Massive Splenic Infarction and Autosplencetomy: First Presentation of Homozygous Sickle Cell Disease in a Toddler

Krepis, Panagiotis; Maritsi, Despoina; Τσολιά, Μαρία; Vakaki, Marina; Kossiva, Lydia

doi:10.1097/mph.0000000000001698

Cited by 3 publications

(3 citation statements)

References 2 publications

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“…However, some patients complained of severe abdominal pain, and several case reports have described serious complications (splenic rupture, peritoneal bleeding, and peritonitis) in MPN patients (19)(20)(21). In Intern Med 61: 3483-3490, 2022 DOI: 10.2169/internalmedicine.9124-21 addition, abscess formation and functional asplenia attributable to splenic infarction have been reported in patients with other clinical conditions (30)(31)(32)(33).…”

Section: Discussionmentioning

confidence: 99%

Splenic Infarction in Patients with Philadelphia-negative Myeloproliferative Neoplasms

et al. 2022

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Objective We retrospectively analyzed the prevalence and clinical features of splenic infarctions in patients with Philadelphia chromosome-negative myeloproliferative neoplasms (Ph -MPNs). Patients Patients diagnosed with essential thrombocythemia (ET), polycythemia vera (PV), prefibrotic/early primary myelofibrosis (pre-PMF), or PMF from January 1996 to October 2020 in Chungnam National University Hospital, Daejeon, Korea, were reviewed. Results A total of 347 patients (143 ET, 129 PV, 44 pre-PMF, and 31 PMF patients; 201 men and 146 women) with a median age of 64 (range 15-91) years old were followed up for a median of 4.7 (range 0.1-26.5) years. Fifteen (4.3%) patients exhibited splenic infarctions at the diagnosis. These were most common in PMF patients (12.9%), followed by pre-PMF (9.1%) and PV (5.4%) patients. Multifocal infarcts (60.0%) were most common, followed by solitary (33.3%) and extensive infarcts (6.7%). The cumulative incidence of thrombosis in patients with splenic infarctions tended to be higher than in those lacking infarctions (10-year incidence 46.7% vs. 21.0% in PV; p=0.215; 33.3% vs. 17.9% in pre-PMF; p=0.473) patients, but statistical significance was lacking. Palpable splenomegaly (hazard ratio 14.89; 95% confidence interval 4.00-55.35; p< 0.001) was the only independent risk factor for splenic infarction. During follow-up, 5 (1.4%) patients developed splenic infarctions. Conservative treatment adequately controlled the symptoms; no serious complications were noted in any patient. Conclusion Splenic infarctions occurred most frequently in patients with PMF; it was rare in patients with ET. The clinical courses were generally mild.

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Section: Discussionmentioning

confidence: 99%

Splenic Infarction in Patients with Philadelphia-negative Myeloproliferative Neoplasms

et al. 2022

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“…Hereditary spherocytosis [52] Sickle cell disease [53][54][55][56][57] Hemoglobin SE disease [58] β-Thalassemia [59] Protein C deficiency [60] Antiphospholipid syndrome [61] Vasculitis ANCA-associated vasculitis [62][63][64] Eosinophilic granulomatosis with polyangiitis [65] Cardiovascular disease, atrial fibrillation Atrial fibrillation [66,67] COVID-19: coronavirus disease 2019; ANCA: anti-neutrophil cytoplasmic antibody. rate (30.7%) was found in patients with infective endocarditis [4].…”

Section: Causes Of Splenic Infarction Referencesmentioning

confidence: 99%

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

et al. 2023

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Background Splenic infarction is a frequently missed diagnosis in acute clinical conditions and is often under-diagnosed due to the lack of high-quality evidence on pathophysiology of splenic infarction. Due to the scarcity of such evidence, no consensus guidelines regarding the diagnostic approach and management of patients with splenic infarction exist. Most of published articles on splenic infarction are case reports and there was no systematic review on splenic infarction. Methods We conducted a retrospective analysis of all radiologically confirmed cases of splenic infarction patients with any history of admission at National Center for Global Health and Medicine Kohnodai Hospital, from 2014 to 2020. Further, to understand the pathophysiology that causes splenic infarction, we searched the literatures on splenic infarction. Results We found 18 patients with splenic infarction. The average age was 78 years, and about half of patients had abdominal pain; however, the other half did not have abdominal pain. One-third of patients with splenic infarction died. Leukocytosis with neutrophilia, a decrease of lymphocytes, anemia, hypoalbuminemia, and liver dysfunction were observed. Fibrinogen was decreased and D-dimer was remarkably elevated. Lactate dehydrogenase (LDH) and C-reactive protein (CRP) were remarkably increased. Six patients (33.3%) had cancer, four patients (22.2%) had atrial fibrillation, and four patients (22.2%) had infection. We found 466 case reports on splenic infarction published from 1975 to 2021. Recently, the number of case reports on splenic infarction due to infection, especially, coronavirus disease 2019 (COVID-19), has been remarkably increasing. Furthermore, we found that leukocytosis, a decrease of lymphocytes, elongated activated partial thromboplastin time, decrease of fibrinogen, liver dysfunction, elevation of LDH and blood urea nitrogen can be the prognosis predicting factors for patients with splenic infarction. Conclusion Our study elucidated clinical, hematological, biochemical and radiological characteristics for patients with splenic infarction. We newly found significant differences in blood cell counts, coagulation markers, transaminases, LDH and blood urea nitrogen between patients who died and those who survived, suggesting that these parameters can be the prognosis predicting factors for splenic infarction. Further, our systematic review on case reports about splenic infarction showed the etiology of splenic infarction and the trend of the causative diseases.

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“…The patient he is currently asymptomatic, and was discharged following the prophylaxis guidelines for splenectomized pediatric patients. Splenic infarction, an infrequent in the pediatric population, may be attributable to multiple etiologies, such as malaria, sickle cell disease [1] and splenic hilum torsion, the latter usually in the context of a wandering spleen [2]. The spleen is located in the peritoneal cavity and is relatively fixed by different groups of ligaments.…”

Section: Main Textmentioning

confidence: 99%

Pediatric Splenic Torsion in an Orthotopic Spleen without Fixation Elements

Antona¹,

Montero²,

Briones³

et al. 2022

The Journal of Pediatrics

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Massive Splenic Infarction and Autosplencetomy: First Presentation of Homozygous Sickle Cell Disease in a Toddler

Cited by 3 publications

References 2 publications

Splenic Infarction in Patients with Philadelphia-negative Myeloproliferative Neoplasms

Splenic Infarction in Patients with Philadelphia-negative Myeloproliferative Neoplasms

Clinical, Hematological, Biochemical and Radiological Characteristics for Patients With Splenic Infarction: Case Series With Literature Review

Pediatric Splenic Torsion in an Orthotopic Spleen without Fixation Elements

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