Document Detail

Hyposplenism: comparison of different methods for determining splenic function.
MedLine Citation:
PMID:  22488175     Owner:  NLM     Status:  MEDLINE    
Asplenic patients are at risk for pneumococcal sepsis. Patients with hyposplenic function, such as associated with sickle cell disease (SCD), are also at risk. However, tests to assess splenic function are either unavailable or lacking standardization. The aim of this study was to compare different methods for determining splenic function. Eighteen patients with SCD (i.e., 10 heterozygous (SC) and 8 homozygous (SS) SCD patients), and eight splenectomized patients were compared to 10 controls. All subjects underwent spleen scintigraphy, after which functional splenic volumes (FSV) were calculated. FSV was compared to immunological function and B cell-subsets, as well as phagocytic function represented by the presence of Howell Jolly bodies (HJB) and percentages of pitted red cells (PIT). Heterozygous SCD (SC) patients had increased splenic volumes, but diminished FSV, homozygous SCD (SS) patients were asplenic. Splenectomized and SS patients had a strongly reduced phagocytic and immunological function. SC patients had reduced anti-polysaccharide responses without an increase in PIT. FSV correlated significantly with phagocytic and immunological function. HJB were indicative of splenic dysfunction, HJB absence was not indicative of normal functioning splenic tissue. Although visualizing HJB is methodologically advantageous to PIT, both are valid biomarkers of splenic dysfunction. The amount of non-switched memory B cells is strongly correlated to FSV.
A J Jolanda Lammers; Alexander P N A de Porto; Roelof J Bennink; Ester M M van Leeuwen; Bart J Biemond; J Carel Goslings; Jan van Marle; Ineke J M ten Berge; Peter Speelman; Joost B L Hoekstra
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Publication Detail:
Type:  Comparative Study; Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-04-10
Journal Detail:
Title:  American journal of hematology     Volume:  87     ISSN:  1096-8652     ISO Abbreviation:  Am. J. Hematol.     Publication Date:  2012 May 
Date Detail:
Created Date:  2012-04-17     Completed Date:  2012-06-19     Revised Date:  2012-11-19    
Medline Journal Info:
Nlm Unique ID:  7610369     Medline TA:  Am J Hematol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  484-9     Citation Subset:  IM    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Department of Infectious Diseases Tropical Medicine and AIDS, Academic Medical Center, Amsterdam, The Netherlands.
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MeSH Terms
Anemia, Sickle Cell / physiopathology
Antibody Formation
Antigens / immunology
Erythrocyte Inclusions / ultrastructure
Erythrocytes, Abnormal / ultrastructure
Immunologic Memory
Lymphocyte Subsets / immunology
Middle Aged
Organ Size
Sickle Cell Trait / physiopathology
Sodium Pertechnetate Tc 99m / diagnostic use
Spleen / pathology,  physiopathology*,  radionuclide imaging
Splenectomy / adverse effects
Splenic Diseases / blood,  diagnosis*,  immunology
Young Adult
Reg. No./Substance:
0/Antigens; 23288-60-0/Sodium Pertechnetate Tc 99m
Comment In:
Am J Hematol. 2012 Oct;87(10):E81-2   [PMID:  22847468 ]

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