title: Splenic Syndrome due to Sickle Cell Trait amongst Indian Soldiers Serving in Kashmir.
abstract: BACKGROUND
  Heterozygous transmission of gene for Haemoglobin S leads to sickle cell trait. Mostly the trait remains silent with no additional morbidity or mortality. When these persons migrate to higher altitudes, in times of high oxygen demand, some of them develop splenic infarction. This is a rare phenomenon and only 47 such cases had been reported till 2005.
  
  
  METHODS
  This study was conducted at an Indian military hospital serving the troops deployed in Kashmir valley at altitudes ranging from 5500 ft to 13000 ft. When two consecutive splenectomies for splenic abscesses, turned out to be sickling induced infarction histopathologically, we reviewed splenectomy specimens received in last six years for evidence of sickling.
  
  
  RESULTS
  Out of 33 splenectomies performed during the period of study, 22 were due to trauma (gun shot injury 11; splinter injury one and blunt injury 10). Of the rest eleven, who presented without any history of trauma, seven had evidence of vascular occlusion with aggregates of sickled red blood cells. In none, Gram stain or Periodic Acid Schiff stain revealed any bacterial or fungal colonies. One patient of splenic syndrome was found to have unrecognised sickle cell trait and he was managed conservatively.
  
  
  CONCLUSIONS
  Sickle cell trait should be excluded before considering splenectomy in ethnically vulnerable patients presenting with splenic syndrome. An uncomplicated splenic infarction can be managed conservatively.
authors.affiliation: Professor & Head (Dept of Biochemistry) Armed Forces Medical College, Pune.
authors.forename: M M
authors.initials: MM
authors.lastname: Arora
authors.affiliation: Graded Specialist (Pathology), Military Hospital, Mathura (UP).
authors.forename: J K
authors.initials: JK
authors.lastname: Bhatia
authors.affiliation: Reader (Dept of Radiodiagnosis) Armed Forces Medical College, Pune.
authors.forename: V
authors.initials: V
authors.lastname: Khanna
authors.affiliation: Graded Specialist (Surgery), Command Hospital (Southern Command), Pune.
authors.forename: P
authors.initials: P
authors.lastname: Jaiswal
authors.affiliation: Classified Specialist (Medicine & Clinical Haematologist), Command Hospital (Northern Command), C/o 56 APO.
authors.forename: V D
authors.initials: VD
authors.lastname: Charan
keywords: Sickle cell trait; Splenic infarction; Splenic syndrome