title: D-dimer and portal vein status in splenectomized Egyptian β-thalassemia major patients: a prospective single-thalassemia center experience.
abstract: Splenectomy is a recognized cause of portal vein thrombosis. Thirty-six β-thalassemia major (β-TM) patients were followed up for 36 months to evaluate changes in D-dimer levels (as a possible marker for thrombosis development) and portal vein status (by portal duplex ultrasound) at both early and late postlaparoscopic splenectomy periods. They were classified into group I if they were splenectomized in the study period (n = 12), or group II if they were splenectomized during the 5 years preceding the period (n = 24). In group I, D-dimer was measured 5 times: 1 day presplenectomy, the 1st week, 6th week, and 6th month postsplenectomy, and at the study end, whereas in group II, D-dimer was measured twice: at the study entry and end. Portal duplex was done 1 week postsplenectomy (group I) and at study end in both groups. Presplenectomy D-dimer levels in group I were significantly higher compared with the 6th month (P = .042) and study end (P = .03), whereas 1st week (postsplenectomy) D-dimer levels had a high mean of 3497.3 ng/mL, lowered at the 6th week (P = .017), at the 6th month (P = .008), and at study end (P = .005). D-dimer levels in group II showed no difference between study entry and end (P = .104). Portal vein "diameter and flow" were within normal findings in both groups. In this 3-year prospective study, a subclinical hypercoagulable state was detected 1 day prior to splenectomy and in the early postsplenectomy period, as evidenced by high D-dimer levels. Laparoscopic splenectomy was not associated with portal venous thrombosis either clinically or by duplex sonography.
authors.affiliation: Department of Pediatric Hematology, Ain Shams University, Cairo, Egypt. elalfym@hotmail.com
authors.forename: Mohsen Saleh
authors.initials: MS
authors.lastname: Elalfy
authors.forename: Nevine Gamal
authors.initials: NG
authors.lastname: Andrawes
authors.forename: Azza Mohamad
authors.initials: AM
authors.lastname: Sadek
authors.forename: Omar
authors.initials: O
authors.lastname: Hussein
authors.forename: Abeer
authors.initials: A
authors.lastname: Abdou
mesh_terms: D000293:Adolescent; D015415:Biomarkers; D002648:Child; D004534:Egypt; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis*; D006801:Humans; D011169:Portal Vein / Q000473:pathology*; D011446:Prospective Studies; D055503:Protein Multimerization; D013156:Splenectomy; D019851:Thrombophilia / Q000209:etiology; D013927:Thrombosis / Q000209:etiology; D017086:beta-Thalassemia / Q000150:complications*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D