Microangiopathic hemolytic anemia with hyposplenism

Bain, Barbara J.; Fosbury, Emma

doi:10.1002/ajh.21301

Cited by 2 publications

(1 citation statement)

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“…[ 58 ] In accordance with this, HJBs have also been reported in some hematological abnormalities, such as iron deficiency anemia, hemolytic anemias, and megaloblastosis. [ 74 , 75 ] Thus, it is reasonable to speculate that the finding of HJBs in peripheral blood smears along with a normal spleen scan might represent the hematological disorders mentioned in renal transplant recipients. However, as no comprehensive study to detect hematological disorders was performed in the present study, it is not possible to confirm this hypothesis.…”

Section: Discussionmentioning

confidence: 99%

Howell-Jolly bodies and liver-spleen scanning for assessment of splenic filtrative function yields discordant results in renal transplant recipients

Araújo¹,

Orlando

Neves

et al. 2017

Medicine

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Given discrepancies between methods for diagnosing hyposplenism, the purpose of this study was to evaluate the effect of the spleen size on the correlation between the methods, and to propose a model for improving the interpretation. Patients with renal allografts were included, in whom the spleen was assessed using Doppler ultrasound, scintiscan, and the presence of Howell-Jolly bodies (HJBs) in peripheral smears. In 35 subjects, scintiscan and HJBs were normal (Group 0); 20 had an abnormal result in both methods (Group 1); 34 had discordant results with HJBs present (Group 2); and 14 had discordant results with decreased spleen uptake (Group 3). There was no association between HJBs and scintiscan. The patients of Groups 1 and 2 had smaller spleens. The patients with smaller spleen had more hematological evidence of hyposplenism and exhibit smaller discrepancies between the methods than patients with larger spleen. The spleen can tip the balance from a normal to impaired function provided that the spleen size is below the critical mass required to maintain splenic function. A mild impairment of phagocytic function and slight dyserythropoiesis along with a small spleen would result in decreased take up of radiocolloid or the appearance of HJBs in blood smears.

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Section: Discussionmentioning

confidence: 99%