The Metabolism of Copper and Iron in Splenectomized Rats Free From Bartonella Muris Infection

Sandberg, Marta; Perla, David

doi:10.1084/jem.60.3.395

Cited by 4 publications

(1 citation statement)

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“…Thus the splenectomy-induced improving effcet on liver function in WD patients might be associated with its effects of anti-fibrosis, beneficial immunological changes and liver arterial blood supply improvement. On the other hand, the copper metabolism alterations after splenectomy might also contribute to the splenectomy-induced improving effcet on liver function in WD patients, as removal of the spleen in rats is followed by an increased elimination of copper in the feces [ 36 ]. Lastly, splenectomy may exert its liver function improvement effect in WD patients through elevating the copper-chelating rate, as it is found that a greater degree of iron overload in splenectomized patients results in improvement of deferiprone-chelated iron, as well as a significant increase in urinary iron excretion in β-thalassaemia patients [ 37 ], though it is the alteration of iron but not copper metabolism.…”

Section: Discussionmentioning

confidence: 99%

Successful Splenectomy for Hypersplenism in Wilson’s Disease: A Single Center Experience from China

Yang

Chen

et al. 2015

PLoS ONE

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Splenomegaly and pancytopenia are common in Wilson’s disease (WD) and splenectomy is one of the conventional treatments for splenomegaly and the associated pancytopenia. However, splenectomy remained controversial for hypersplenism in WD as it was reported that splenectomy leaded to serious emotional and neurological deterioration in WD patients with hypersplenism. In the current study, we present our experiences in 70 WD patients with hypersplenism who had undergone splenectomy, outlining the safety and efficacy of splenectomy in WD. The clinical database of 70 WD patients with hypersplenism who had undergone splenectomy in our hospital between 2009 and 2013 were reviewed and followed-up regularly. Before splenectomy, all the patients accepted a short period of anti-copper treatment with intravenous sodium 2, 3-dimercapto-1-propane sulfonate (DMPS). All the patients demonstrated a marked improvement in platelet and leucocyte counts after splenectomy. No severe postoperative complication was observed. In particular, none of the 37 patients with mixed neurologic and hepatic presentations experienced neurological deterioration after splenectomy, and none of the patients with only hepatic presentations newly developed neurological symptoms. During the one year follow-up period, no patient presented hepatic failure or hepatic encephalopathy, no hepatic patient newly developed neurological presentations, and only 3 patients with mixed neurologic and hepatic presentations suffered neurological deterioration and these 3 patients had poor compliance of anti-copper treatment. Quantative analysis of the neurological symptoms in the 37 patients using the Unified Wilson’s Disease Rating Scale (UWDRS) showed that the neurological symptoms were not changed in a short-term of one week after splenectomy but significantly improved in a long-term of one year after splenectomy. Additionally, compared to that before splenectomy, the esophageal gastric varices in most patients significantly improved one year after splenectomy. Thus, we may conclude that splenectomy is a safe and effective therapeutic measure for hypersplenism in WD patients who had been preoperatively treated with DMPS for powerful anti-copper therapy.

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Section: Discussionmentioning

confidence: 99%