“…On the other hand splenectomy performed on younger children may be followed by severe infections (Horan and Colebatch, 1962; Motulsky et al, 1958). …”
Section: Problems Concerning the P(ltierdsmentioning
Within 10 years (1964 -1974) •two hundred and twenty one ' Beside the medical points of view thalassemia has also many social aspects to be considered, those of the cM1d itself, the parents and the society or community.
“…On the other hand splenectomy performed on younger children may be followed by severe infections (Horan and Colebatch, 1962; Motulsky et al, 1958). …”
Section: Problems Concerning the P(ltierdsmentioning
Within 10 years (1964 -1974) •two hundred and twenty one ' Beside the medical points of view thalassemia has also many social aspects to be considered, those of the cM1d itself, the parents and the society or community.
“…In addition, since their cooperative ability was found to be regenerated even several weeks after spleen removal, the splenic influence may be continuously expressed throughout the lifetime of an animal. A possible analogy to this syngeneic spleen cell replacement in neonatally splenectomized mice is a condition that has been observed in human infants (12). Splenectomy in infants during the 1st yr of life resulted in serious infections except in cases of traumatic rupture of the spleen.…”
Section: Restoration Of Cooperative Ability To B and T Cellsmentioning
Bone marrow (B) and thymic (T) cells taken from adult mice that had been splenectomized within 24 hr of birth showed an inability to cooperate in the IgM response to sheep red blood cells. The defect in collaborative capacity was apparent in both sets of cells, but appeared to be more pronounced in the T cell population. Splenectomy performed at various neonatal intervals indicated that if removal of the spleen were delayed until 6 days after birth, B and T cells of the adult showed a 60% restoration in cooperation. Replenishment of the synergistic ability after neonatal splenectomy could be achieved by injecting spleen cells immediately after spleen removal or 2 months postsplenectomy.
“…M. Horan and J. H. Colbach reported serious sepsis in 50 percent of their splenectomized patients under the age of 12 months while only 2.8 percent of those patients who underwent splenectomy between the ages of 1 and 16 years had similar infections. 9 In splenectomized patients of all ages, serious sepsis occurred in 3.52 percent; in infants who underwent splenectomy for the same reason, the incidence was 21.0 percent. The age at the time of splenectomy, therefore, plays a crucial role in predisposing the patient to the risk of sepsis, regardless of the underlying hematological or surgical condition.…”
Section: Incidence Of Postsplenectomy Sepsismentioning
confidence: 98%
“…9,13 The interval has been as short as 13 days and as long as 25 years. 3,14 The authors are aware of an unpublished case of a man who died from pneumococcal sepsis 32 years after undergoing splenectomy at the age of two years for congenital spherocytosis.…”
Section: Clinical Features Of the Syndromementioning
Overwhelming postsplenectomy sepsis occurs in 1.5 to 24.8 percent of splenectomized individuals. Two factors influence its incidence: age at the time of splenectomy and the underlying condition for which the spleen was removed. The infection is fatal in 50 to 80 percent of cases and the most common organism responsible is the pneumococcus. Oral penicillin and the polyvalent pneumococcal vaccine provide some protection against pneumococcal sepsis. Twenty-three children underwent splenectomies at the King Faisal Specialist Hospital and Research Centre over a period of five years. Two of these children developed serious sepsis. In addition, two children who underwent splenectomy in other hospitals were admitted to King Faisal Specialist Hospital and Research Centre in septic shock. None of these children was taking penicillin at the time sepsis occurred and only one child had been vaccinated.
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