title: Splenic infarction after Epstein-Barr virus infection in a patient with hereditary spherocytosis.
abstract: We describe the first patient with hereditary spherocytosis (HS) known to have developed splenic infarction following infectious mononucleosis (IM). An 18-year-old Japanese man was referred to our hospital in November 2004 because of continuous fever and icterus. He had undergone cholecystectomy at the age of 14 years. On patient admission in November 2004, a physical examination showed marked hepatosplenomegaly, icterus, and jaundice. He had a white blood cell count of 14.9 x 10(9)/L with 9.5% atypical lymphocytes, a red blood cell count of 2.93 x 10(12)/L, and a hemoglobin concentration of 7.8 g/dL. Microspherocytes were observed in the patient's peripheral blood smear, and immunoglobulin M antibody to Epstein-Barr virus (EBV) viral capsid antigen was detected. The patient's diagnosis was HS with IM. On day 4 of admission, the patient complained of severe abdominal pain. Abdominal computed tomography scanning revealed findings of splenic infarction. Two months after the occurrence of splenic infarction, a splenectomy was performed. A pathohistologic examination of the resected spleen revealed no evidence of thrombosis or arterial occlusion. We assume that the cause of splenic infarction was insufficient blood flow to oxygenate the entire spleen during the acute enlargement of the spleen.
authors.affiliation: Department of Hematology, Kitasato University School of Medicine, Sagamihara, Japan. ytsunoda@med.kitasato-u.ac
authors.forename: Yuhko
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Shichishima
authors.forename: Miyuki
authors.initials: M
authors.lastname: Mukae
authors.forename: Manabu
authors.initials: M
authors.lastname: Ohsaka
authors.forename: Miyuki
authors.initials: M
authors.lastname: Hayama
authors.forename: Ryouichi
authors.initials: R
authors.lastname: Horie
authors.forename: Tomiteru
authors.initials: T
authors.lastname: Togano
authors.forename: Koji
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Masaaki
authors.initials: M
authors.lastname: Ichinoe
authors.forename: Keiichi
authors.initials: K
authors.lastname: Iwabuchi
authors.forename: Hisaichi
authors.initials: H
authors.lastname: Fujii
authors.forename: Masaaki
authors.initials: M
authors.lastname: Higashihara
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D007244:Infectious Mononucleosis / Q000150:complications*; D008297:Male; D013103:Spherocytosis, Hereditary / Q000150:complications* / Q000473:pathology; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed