Splenectomy in sarcoidosis: indications, complications, and long-term follow-up.
BACKGROUND
Management of splenic enlargement due to sarcoidosis consists of primarily medical therapy with prednisone, methotrexate or antimalarial drugs. Splenectomy is the last resort because of the concern about complications of surgery.


OBJECTIVE
This study was conducted to explore indications for splenectomy in sarcoidosis and to assess if complications associated with splenic removal were unacceptable.


RESULTS
13 sarcoidosis patients had their spleens removed for one or more of the following four reasons: (1) Massive splenomegaly; (2) Severe hypersplenism; (3) Need for excluding lymphoma or malignancy; and (4) Precaution against splenic rupture. All patients received strict prophylactic protocol and were followed over a period ranging from 1 to 30 years.


CONCLUSIONS
In this long term follow-up study none of the thirteen patients developed serious infections or sepsis. No deaths occurred that might be related to splenectomy.
Sharma
Om P
OP
LAC+USC Medical Center, Los Angeles, CA, USA. osharma@hsc.usc.edu
Vucinic
Violeta
V
James
D Geraint
DG
D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006971:Hypersplenism / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000150:complications*; D013156:Splenectomy; D013163:Splenomegaly / Q000209:etiology / Q000601:surgery*; D013997:Time Factors