title: Autosplenectomy in severity of sickle cell diseases.
abstract: BACKGROUND
  We tried to understand whether or not there is an association between prevalence of autosplenectomy and severity of sickle cell diseases (SCDs).
  
  
  METHODS
  All SCDs patients with red blood cell (RBC) transfusions of less than 50 units in their lives were put into the first group and 50 units or higher were put into the second group.
  
  
  RESULTS
  The study included 316 patients (155 females). There were 224 cases (70.8%) in the first group and 92 cases (29.1%) in the second group (p<0.001). The male ratio was significantly higher in the second group (64.1% versus 45.5%, p<0.001). Although both the white blood cell and platelet counts were higher in the second group, there was a significant difference in platelet counts (p=0.005), and this was probably due to the small sample sizes. Although the prevalence of autosplenectomy was significantly higher in the first group (56.2% versus 45.6%, p<0.05), the mean number of painful crises per year, digital clubbing, chronic obstructive pulmonary disease (COPD), leg ulcers, stroke, chronic renal disease (CRD) and coronary heart disease (CHD) were significantly higher in the second groups (p<0.05 for all).
  
  
  CONCLUSIONS
  In contrast to the lower prevalence of autosplenectomy, the mean number of painful crises per year, digital clubbing, COPD, leg ulcers, stroke, CRD, and CHD were significantly higher in the second group. So there may be an inverse relationship between prevalence of autosplenectomy and severity of SCDs, and spleen may act as a chronic inflammatory focus as a filter of blood for these abnormally hard RBCs.
authors.affiliation: Medical Faculty of The Mustafa Kemal University Antakya.
authors.forename: Mehmet Rami
authors.initials: MR
authors.lastname: Helvaci
authors.affiliation: Medical Faculty of The Mustafa Kemal University Antakya.
authors.forename: Can
authors.initials: C
authors.lastname: Acipayam
authors.affiliation: Medical Faculty of The Mustafa Kemal University Antakya.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Davran
keywords: Autosplenectomy; chronic capillary damage; sickle cell diseases