title: Splenectomy for massive splenic infarction unmasks paroxysmal nocturnal hemoglobinuria.
abstract: Paroxysmal nocturnal hemoglobinuria (PNH) is a rare disorder characterized by pancytopenia, hemolysis, and thrombosis. Abdominal vein thrombosis is a life-threatening manifestation of this disease. We present a patient with complete spleen necrosis due to thrombosis of the splenic vessels. After splenectomy, other causes of thrombophilia were excluded and the diagnosis of PNH was established. The patient was put on anticoagulation but despite the prophylactic international normalized ratio maintained over the last 18 months of follow-up, he had another episode of intrahepatic thrombosis which was treated with tissue plasminogen activator thrombolysis.
authors.affiliation: Department of Hematology, School of Medicine, Democritus University of Thrace, Alexandroupolis, Greece. ktsatala@med.duth.gr
authors.forename: Costas
authors.initials: C
authors.lastname: Tsatalas
authors.forename: Dimitris
authors.initials: D
authors.lastname: Margaritis
authors.forename: Despina
authors.initials: D
authors.lastname: Pantelidou
authors.forename: Ioannis
authors.initials: I
authors.lastname: Kotsianidis
authors.forename: Anastasios J
authors.initials: AJ
authors.lastname: Karayiannakis
authors.forename: Emanuel
authors.initials: E
authors.lastname: Spanoudakis
authors.forename: Zafiris
authors.initials: Z
authors.lastname: Kartasis
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Kaloutsi
authors.forename: Alexandros
authors.initials: A
authors.lastname: Polychronidis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Manavis
authors.forename: George
authors.initials: G
authors.lastname: Bourikas
mesh_terms: D000328:Adult; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D008297:Male; D013156:Splenectomy; D013159:Splenic Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed