Liver dysfunction following splenectomy in idiopathic myelofibrosis: a study of 10 patients.
The hepatic abnormalities that developed after the splenectomy in 10 subjects with idiopathic myelofibrosis were analyzed. In all patients in whom a liver biopsy was performed during the splenectomy, extramedullary hematopoiesis was demonstrated, consisting of dysmorphic megakaryocytes primarily localized in the sinusoids, often accompanied by erythroid precursors. Following splenectomy, a significant increase in both the liver size and serum levels of alkaline phosphatase, bilirubin or gamma-glutamyl transpeptidase was found within 6 months, whereas no such increase was observed in the serum aspartate transaminase and alanine transaminase concentrations. In addition, 2 patients developed acute liver failure leading to death at 3 and 4 weeks from splenectomy, respectively. In contrast with these findings, no hepatic alterations were observed in 10 chronic myeloid leukemia patients who were also submitted to splenectomy.
Postgraduate School of Hematology Farreras Valentí, University of Barcelona, Spain.
A
A
López-Guillermo
F
F
Cervantes
M
M
Bruguera
A
A
Pereira
E
E
Feliu
C
C
Rozman
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001663:Bilirubin / Q000097:blood; D005260:Female; D006411:Hematopoiesis, Extramedullary; D006412:Hematopoietic Stem Cells / Q000473:pathology; D006801:Humans; D007728:Kupffer Cells / Q000473:pathology; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D008297:Male; D008533:Megakaryocytes / Q000473:pathology; D008875:Middle Aged; D055728:Primary Myelofibrosis / Q000601:surgery*; D013156:Splenectomy / Q000009:adverse effects*; D005723:gamma-Glutamyltransferase / Q000097:blood
D005723:gamma-Glutamyltransferase; D000469:Alkaline Phosphatase; D001663:Bilirubin