title: Improving cytopenia with splenic artery embolization in a patient with paroxysmal nocturnal hemoglobinuria on eculizumab.
abstract: Paroxysmal nocturnal hemoglobinuria is a rare acquired stem cell disorder characterized by intravascular hemolysis, aplasia and an increased risk of thrombosis. We describe a patient under treatment with the anti-complement antibody eculizumab who developed pancytopenia, requiring blood transfusions, due to massive splenomegaly. The patient underwent two separate splenic embolizations, which reduced the size of the spleen and improved his blood count to the point that blood transfusions were no longer necessary. Splenic embolization was chosen over splenectomy due to the potential postoperative complications of splenectomy, especially that of thrombosis.
authors: Department of Hematology/Oncology, St-James University Hospital, Beckett Street, Leeds, LS9 7TF, UK, drskkrishnan@gmail.com.
authors: Suresh K
authors: SK
authors: Krishnan
authors: Anita
authors: A
authors: Hill
authors: Peter
authors: P
authors: Hillmen
authors: Louise M
authors: LM
authors: Arnold
authors: Gemma L
authors: GL
authors: Brooksbank
authors: Alex
authors: A
authors: Wood
authors: Andrew
authors: A
authors: Scarsbrook
authors: Mervyn H
authors: MH
authors: Davies
authors: Richard J
authors: RJ
authors: Kelly
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D001803:Blood Transfusion; D004621:Embolization, Therapeutic; D006457:Hemoglobinuria, Paroxysmal / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged; D010198:Pancytopenia / Q000209:etiology* / Q000628:therapy; D013154:Spleen / Q000473:pathology; D013157:Splenic Artery / Q000473:pathology; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; C481642:eculizumab