Non hypoxia-related splenic infarct in a patient with sickle cell trait and infectious mononucleosis.
Splenic infarction in patients with sickle cell trait is usually related to hypoxic conditions, while non-hypoxia-related infarcts are extremely rare. We report on a case of a 17-year-old male patient, living at sea level, who developed a severe left upper quadrant abdominal pain during the course of a febrile episode. On physical examination he had a mildly palpable but extremely painful spleen. A spleen scan revealed 2 areas of impaired radionucleide distribution. Hepatic enzymes were moderately increased and the IgM anti-EBV antibodies positive. Hemoglobin electrophoresis revealed the presence of 42% of hemoglobin S. A probable diagnosis of splenic infarction was established in a patient with sickle cell trait, during the course of infectious mononucleosis. The patient was treated symptomatically. The conditions of splenic congestion induced by the EBV infection and the high-grade fever may have contributed to splenic sequestration and subsequent infarcts.
Symeonidis
A
A
Hematology Division, University of Patras Medical School, PO Box 1045, 261.10 Patras, Greece. argisym@hotmail.com
Papakonstantinou
C
C
Seimeni
U
U
Sougleri
M
M
Kouraklis-Symeonidis
A
A
Lambropoulou-Karatza
C
C
Vagenakis
A
A
Zoumbos
N
N
D000293:Adolescent; D000914:Antibodies, Viral / Q000097:blood; D005334:Fever; D006451:Hemoglobin, Sickle / Q000032:analysis; D004854:Herpesvirus 4, Human / Q000276:immunology; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D007244:Infectious Mononucleosis / Q000150:complications*; D008099:Liver / Q000000981:diagnostic imaging / Q000201:enzymology; D008297:Male; D010146:Pain; D010173:Palpation; D011877:Radionuclide Imaging; D012805:Sickle Cell Trait / Q000150:complications*; D013154:Spleen / Q000000981:diagnostic imaging; D013159:Splenic Infarction / Q000175:diagnosis* / Q000209:etiology
D000914:Antibodies, Viral; D006451:Hemoglobin, Sickle; D007075:Immunoglobulin M