title: An extreme consequence of splenectomy in dehydrated hereditary stomatocytosis: gradual thrombo-embolic pulmonary hypertension and lung-heart transplantation.
abstract: Dehydrated hereditary stomatocytosis (DHS) belongs to the heterogeneous class of hemolytic anemias with leaky red cell membranes. Splenectomy is a highly deleterious treatment, because it favors, with virtually no exception, the occurrence of thromboembolic disease. We describe here the extreme case of a patient with DHS and an associated sickle cell trait. Splenectomy was carried out due to a splenic infarction that occurred during an airplane journey. About 12 years later, the patient noticed an exertional dyspnea, which gradually worsened to such a degree that she became severely incapacitated within 5 years. Eventually, the patient developed a cor pulmonale associated with chronic thromboembolic pulmonary hypertension (CTEPH) and successfully underwent a heart-lung transplant operation. This case ranks as one of the most severe examples ever recorded of the effect that splenectomy may have in DHS patients. Nonetheless, it represents the first case to receive a heart-lung transplant.
authors.affiliation: UPRES EA 2705, Service de Pneumologie, Hôpital Antoine-Béclère (AP-HP, Université Paris-Sud), Clamart, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Jaïs
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Till
authors.forename: Thérèse
authors.initials: T
authors.lastname: Cynober
authors.forename: Vincent
authors.initials: V
authors.lastname: Ioos
authors.forename: Gilles
authors.initials: G
authors.lastname: Garcia
authors.forename: Gil
authors.initials: G
authors.lastname: Tchernia
authors.forename: Philippe
authors.initials: P
authors.lastname: Dartevelle
authors.forename: Gérald
authors.initials: G
authors.lastname: Simonneau
authors.forename: Jean
authors.initials: J
authors.lastname: Delaunay
authors.forename: Marc
authors.initials: M
authors.lastname: Humbert
mesh_terms: D000328:Adult; D000745:Anemia, Hemolytic, Congenital / Q000150:complications / Q000601:surgery*; D000755:Anemia, Sickle Cell / Q000150:complications; D004417:Dyspnea; D005260:Female; D016041:Heart-Lung Transplantation; D006801:Humans; D006976:Hypertension, Pulmonary / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011655:Pulmonary Embolism / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D013156:Splenectomy / Q000009:adverse effects*; D016896:Treatment Outcome