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The spleen has intrigued physicians and philosophers since ancient times. Clinical manifestations of functional hyposplenism OPSI is a septic syndrome encountered in splenectomised patients, characterised by the following features 9 – National Center for Biotechnology Information , U. The presence of pitted red cells identified by interference-contrast microscopy is perhaps the most specific blood finding of hyposplenism, followed by Howell-Jolly bodies. The presence of splenomegaly in a patient with blood cytopenias is useful to narrow the etiology, although trapping in the enlarged spleen may not be the cause of the blood cytopenias. Antibiotic prophylaxis is not routinely suggested for all patients with FH. Peripheral blood thrombocytosis can also exist and might lead to increased risk of thromboembolic events, especially during the first weeks after the establishment of FH 2. It is characterised mostly by defective immune responses against infectious agents, especially encapsulated organisms, since the spleen is thought to play an important role in the production and maturation of B-memory lymphocytes and other substances like opsonins, both of which are considered crucial elements of the immune system for fighting infections.

Significantly important low levels of both B-memory lymphocytes and opsonins have been found in patients with FH in various studies 6 , 7. Hypersplenism can occur with moderate or minimal splenic enlargement as a result of exaggerated removal of physically abnormal e. Please review our privacy policy. Planned, where prophylactic measures can be used to prevent later complications. By using this site you agree to our use of cookies. Clinical Sports Medicine Collection. View All Subscription Options.

Functional hyposplenism diagnosed by blood film examination

Join the discussion on the forums. The spleen is involved in producing protective humoral antibodies, the production and maturation of B and T cells and plasma cells, hyposplnic of unwanted particulate matter eg, bacteria and also acting as a reservoir for blood cells, especially white cells and platelets.


It should be also advised to the patient to keep a supply of penicillin or amoxicillin ready to use in the same occasion.

The basic methods are: Articles from Hippokratia are provided here courtesy of Hippokratio General Hospital of Thessaloniki. Sign in via Shibboleth.

Splenectomy and Hyposplenism

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Opsonised microorganisms are easily recognized and removed by macrophages. National Center for Biotechnology InformationU. Health Tools Feeling unwell? This article is for information only and should not be used for the diagnosis or treatment of medical conditions.

Hypersplenism is defined as one or more blood cytopenias in the setting of splenomegaly. Doncaster and Bassetlaw Hospitals Guidelines for management of asplenic patients.

Splenectomy, Hyposplenism and Asplenia Information Page | Patient

Prevention of serious infections and OPSI in patients with FH is achieved mostly through vaccine and antibiotic prophylaxis. The basic methods are:. Another important region of the white pulp is the featuees lymphatic sheath, which consists of nodules containing mostly B lymphocytes. Postsplenectomy sepsis and its mortality rate: Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy.

Direct toxic effect of alcohol is implied in all disorders caused by acute or chronic alcohol consumption. Ultrasonography showed a normal-sized spleen, but a radionuclide liver-spleen scan revealed no splenic uptake.

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Introduction The integrity and proper function jyposplenic the spleen are considered important for the protection against blood diseases in the adult.


Guidelines for prevention of serious infections in patients with functional hyposplenism Prevention of serious infections and OPSI in patients with FH is achieved mostly through vaccine and antibiotic prophylaxis. Splenomegaly can occur as a result of vascular engorgement or cellular infiltration, and it is frequently associated with a combination of neutropenia, thrombocytopenia, and anemia.

These are recommended in patients at high risk of pneumococcal infections and the hyosplenic of choice are blod phenoxymethylpenicillin or macrolides.

National guidelines recommend the following: Immunization of patients at risk seems to be the most effective measure and vaccination against pneumococcus should probably be applied to all hyposplenic subjects.

Functional hyposplenism diagnosed by blood film examination

Table 1 Main causes of functional hyposplenism. Features such as underlying disease, age, microorganism involved and immune-compromise are considered important for determining the frequency and severity of OPSI in different patients.

These blood film changes are commonly seen in hyposplenism, which can occur in the congenital absence of spleen, sickle cell disease, celiac disease, vasculitis, ulcerative colitis, essential thrombocythemia, and after splenectomy. B-1a B cells that link the innate and adaptive immune responses are lacking in the absence of the spleen. According to others Australasian Society for Infectious Diseases 21antibiotics should be only given for two years after diagnosing FH, as the risk of OPSI has not proved to be the same in all diseases.

Conflict of interest Authors report no conflict of interest.