title: Splenectomy: a strong risk factor for pulmonary hypertension in patients with thalassaemia.
abstract: OBJECTIVE
  To determine the association between splenectomy and pulmonary hypertension in patients with thalassaemia with anaemia.
  
  
  METHODS
  Prospective cross-sectional study.
  
  
  METHODS
  68 patients with thalassaemia, who had a haemoglobin concentration of less than 100 g/l, were recruited into this study. Echocardiography was performed before clinical data were reviewed. Pulmonary artery pressure was estimated by measuring the systolic transtricuspid pressure gradient from tricuspid regurgitation and adding it to the right atrial pressure, which was estimated by the response of the inferior vena cava to inspiration. Pulmonary hypertension was defined as systolic pulmonary artery pressure > 35 mm Hg. History of splenectomy and other clinical data were compared between patients with and without pulmonary hypertension.
  
  
  RESULTS
  29 patients had pulmonary hypertension and 39 did not. Patients with pulmonary hypertension had significantly more nucleated red blood cells and higher platelet counts, and a higher prevalence of splenectomy (75.8% v 25.6%, odds ratio 9.1, 95% confidence interval 3.0 to 27.7). In multivariate analysis, splenectomy was the only factor significantly related to pulmonary hypertension.
  
  
  CONCLUSIONS
  Splenectomy is a strong risk factor for pulmonary hypertension in patients with thalassaemia.
authors.affiliation: Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand. apromint@mail.med.cmu.ac.th
authors.forename: A
authors.initials: A
authors.lastname: Phrommintikul
authors.forename: A
authors.initials: A
authors.lastname: Sukonthasarn
authors.forename: R
authors.initials: R
authors.lastname: Kanjanavanit
authors.forename: W
authors.initials: W
authors.lastname: Nawarawong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D015150:Echocardiography, Doppler; D005260:Female; D006801:Humans; D006976:Hypertension, Pulmonary / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D013156:Splenectomy / Q000009:adverse effects*; D013789:Thalassemia / Q000150:complications*