[Accessory spleen causing recurrent idiopathic thrombocytopenic purpura (case report)].
Idiopathic thrombocytopenic purpura is an autoimmune disease in which macrophages of reticuloendothelial system, mainly in the spleen, remove platelets covered by autoantibodies from circulation. By removing the spleen 60-80% of patients are cured. Partial remission is achieved in 10-20% of cases. Recurrence of idiopathic thrombocytopenic purpura in a splenectomized patient achieving complete remission, may be caused by hypertrophy of one or more of the retained accessory spleens. We describe a 41-year-old wonam in whom splenectomy for idiopathic thrombocytopenic purpura was performed 10 years ago. After quick and full remission which lasted almost 10 years, a full reccurrence of the disease with severe thrombocytopenia and haemorhagic syndrome appeared. With ultrasonography, computed tomography and scintigraphy accessory spleens in the splenic fossa were found. Removal of 3 accessory spleens, 21 gram of weight, led to quick and full remission of the disease. A number of platelets stayed over 200 x 10(9)/l with no additional treatment.
Colović
M
M
Kostić
K
K
Colović
R
R
Perisić-Savić
M
M
Milosević
R
R
D000328:Adult; D005260:Female; D006801:Humans; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000209:etiology* / Q000601:surgery; D012008:Recurrence; D013154:Spleen / Q000002:abnormalities*; D013156:Splenectomy