[Infectious complications after surgical splenectomy in children with sickle cell anemia disease].
OBJECTIVE
To evaluate the frequency of infectious complications in children with sickle cell disease (SCD) after surgical splenectomy for acute splenic sequestration crisis.


METHODS
Retrospective cohort of children with SCD who were born after 2002 and were regularly monitored until July 2013. Patients were divided into two groups: cases (children with SCD who underwent surgical splenectomy after an episode of splenic sequestration) and controls (children with SCD who did not have splenic sequestration and surgical procedures), in order to compare the frequency of invasive infections (sepsis, meningitis, bacteremia with positive blood cultures, acute chest syndrome and/or pneumonia) by data collected from medical records. Data were analyzed by descriptive statistical analysis.


RESULTS
44 patients were included in the case group. The mean age at the time of splenectomy was 2.6 years (1-6.9 years) and the mean postoperative length of follow-up was 6.1 years (3.8-9.9 years). The control group consisted of 69 patients with a mean age at the initial follow-up visit of 5.6 months (1-49 months) and a mean length of follow-up of 7.2 years (4-10.3 years). All children received pneumococcal conjugate vaccine. No significant difference was observed between groups in relation to infections during the follow-up.


CONCLUSIONS
Surgical splenectomy in children with sickle cell disease that had splenic sequestration did not affect the frequency of infectious complications during 6 years of clinical follow-up.
Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
Cypriano Petrus
CP
Monaco Junior
Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil. Electronic address: patricia_blum@uol.com.br.
Patricia Belintani Blum
PB
Fonseca
Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brasil.
Josefina Aparecida Pellegrini
JA
Braga
D000208:Acute Disease; D000755:Anemia, Sickle Cell / Q000150:complications*; D001424:Bacterial Infections / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D006801:Humans; D007223:Infant; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D013156:Splenectomy / Q000009:adverse effects*; D013158:Splenic Diseases / Q000209:etiology* / Q000601:surgery*
Acute splenic sequestration; Doença falciforme; Esplenectomia; Infection; Infecção; Sequestro esplênico; Sickle cell disease; Splenectomy