Acute splenic complications and implications of splenectomy in hemoglobin SC disease.
Splenectomy indications and outcome were evaluated in 124 adults with hemoglobin SC disease (Hb SC). Twelve patients (9.6%) required splenectomy. There was a significant difference between the splenectomy group and the non-splenectomy group, respectively, regarding Hb levels (median 7.2 g/dL vs. 12.5 g/dL, P < 0.0001), platelet counts (median 146 x 10(6)/L vs. 275 x 10(6)/L, P = 0.031), palpable spleen rate (66% vs. 16%, P = 0.0003%), acute chest syndrome frequency (75% vs. 12%P = 0.0004) and cholecystectomy rate (66% vs. 13%, P = 0.0004). No significant morbidity or mortality occurred postsplenectomy. There is a subgroup of Hb SC patients requiring splenectomy, in which splenectomy is effective. Although it appears to be safe regarding short-term complications of surgery, long-term adverse effects such as infections have to be evaluated cautiously.
Subbannan
Karthi
K
Department of Medicine, Section of Hematology/Oncology, Sickle Cell Center, Medical College of Georgia, Augusta, Georgia 30912, USA.
Ustun
Celalettin
C
Natarajan
Kavita
K
Clair
Betsy
B
Daitch
Lisa
L
Fields
Sabine
S
Kutlar
Ferdane
F
Kutlar
Abdullah
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006450:Hemoglobin SC Disease / Q000150:complications* / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D012805:Sickle Cell Trait / Q000150:complications / Q000175:diagnosis; D013156:Splenectomy / Q000379:methods*; D013158:Splenic Diseases / Q000150:complications* / Q000175:diagnosis; D013921:Thrombocytopenia / Q000175:diagnosis; D016896:Treatment Outcome