title: [Functional asplenia after severe varicella zoster-infection diagnosis by colour Doppler ultrasound].
abstract: Infiltrative, inflammatory or thromboembolic processes in the parenchyma of the spleen can cause a functional loss of the organ. This phenomenon is called functional asplenia and occurs as a complication especially in sickle cell disease, lupus erythematosus and after bone marrow transplantation. We present the case of a patient with Crohn's disease under immunosuppressive therapy who developed a spontaneous covered spleen rupture in the course of a septic shock with DIG due to a Varizella zoster infection. Later on, sonography showed a diminution of the spleen size. No flow signals could be derived by colour doppler measurements from the spleen. Because of the colour doppler findings we suspected a functional asplenia which was then verified by spleen scintigraphy and Howell-Jolly-Bodies in the blood count. Remarkably, the Crohn's disease remains in complete remission since the development of the functional asplenia (for 4 years now). The underlying pathomechanism remains unclear.
authors.affiliation: Zentrum für Innere Medizin, Abteilung für Innere Medizin mit Schwerpunkt Gastroenterologie, Stoffwechsel, Endokrinologie, Klinikum der Philipps-Universität Marburg.
authors.forename: J
authors.initials: J
authors.lastname: Diedrich
authors.forename: C
authors.initials: C
authors.lastname: Görg
authors.forename: R
authors.initials: R
authors.lastname: Eissele
authors.forename: R
authors.initials: R
authors.lastname: Arnold
mesh_terms: D000328:Adult; D001284:Atrophy; D001379:Azathioprine / Q000008:administration & dosage / Q000009:adverse effects; D003424:Crohn Disease / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000276:immunology; D004359:Drug Therapy, Combination; D005500:Follow-Up Studies; D006562:Herpes Zoster / Q000000981:diagnostic imaging* / Q000276:immunology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D009894:Opportunistic Infections / Q000000981:diagnostic imaging* / Q000276:immunology; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects; D012422:Rupture, Spontaneous; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D013159:Splenic Infarction / Q000000981:diagnostic imaging* / Q000276:immunology; D013161:Splenic Rupture / Q000000981:diagnostic imaging* / Q000276:immunology; D018615:Ultrasonography, Doppler, Color
chemical_list: D007166:Immunosuppressive Agents; D011239:Prednisolone; D001379:Azathioprine
vernacular_title: Autosplenektomie nach Varizellensepsis bei einem Patienten mit M. Crohn unter immunsuppressiver Therapie.