title: Splenic enlargement in adults with homozygous sickle cell disease: the Jamaican experience.
abstract: OBJECTIVE
  It is quite rare to find splenomegaly or its various complications in adults with homozygous sickle cell (SS) disease. Splenomegaly in adults may indicate a differential severity of disease, when compared with those who have had 'autosplenectomy'.
  
  
  METHODS
  We studied the clinical and haematological profiles of all SS patients (n = 25) in our database who have had splenomegaly in their adulthood (group 1) and compared with a random sample of age- and gender-matched persons (n = 75) who  did not have splenomegaly in adulthood (group 2).
  
  
  RESULTS
  Group 1 persons had higher foetal haemoglobin, lower platelets and white blood cells, and greater prevalence of gall bladder disease and hospitalizations. Seven of the 25 persons in group 1 had acute splenic sequestration  and the rest had hypersplenism.
  
  
  CONCLUSIONS
  Splenic enlargement occurring during adulthood may imply lower severity of disease and clinicians should consider this diagnosis even in persons with SS genotype.
authors: Sickle Cell Unit, Tropical Medicine Research Institute, University of the West Indies, Mona, Jamaica, WI0000. monika.parshadasnani@uwimona.edu.jm
authors: Monika R
authors: MR
authors: Asnani
authors: A
authors: A
authors: Williams
authors: M
authors: M
authors: Reid
mesh_terms: D000293:Adolescent; D000328:Adult; D000755:Anemia, Sickle Cell / Q000453:epidemiology / Q000235:genetics / Q000473:pathology* / Q000601:surgery; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D013163:Splenomegaly / Q000097:blood* / Q000453:epidemiology / Q000235:genetics; D055815:Young Adult