Document Detail


Management of splenectomy failures in chronic immune thrombocytopenic purpura: role of accessory splenectomy.
MedLine Citation:
PMID:  3469969     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Accessory splenic tissue was demonstrated in four of eight patients with chronic immune thrombocytopenic purpura investigated following post-splenectomy relapses. Time from initial splenectomy to relapse of thrombocytopenia ranged from immediately to eight years and post-splenectomy changes were present on the peripheral blood films of all patients at time of relapse. Three scanning techniques were employed to demonstrate and localise residual splenic tissue. Conventional 99mTc scans were positive in three of the four patients whilst 99mTc-heat damaged red cell scans and computerised tomographic scans were each positive in three out of three patients including the one patient in whom a conventional 99mTc scan was negative. Histological confirmation of splenic tissue was obtained in all cases with the weights of the accessory spleens ranging from 0.6 g to 2 g. Two patients responded to accessory splenectomy and, without immunosuppressive therapy, have remained well with normal platelet counts for over four years. There was no correlation between length of initial remission and the response to removal of the accessory spleen. The presence of a functioning accessory spleen should be considered in all patients with chronic ITP who fail to respond to, or relapse following, initial splenectomy.
Authors:
J Gibson; K A Rickard; G Bautovich; J May; H Kronenberg
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Australian and New Zealand journal of medicine     Volume:  16     ISSN:  0004-8291     ISO Abbreviation:  Aust N Z J Med     Publication Date:  1986 Oct 
Date Detail:
Created Date:  1987-03-30     Completed Date:  1987-03-30     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1264322     Medline TA:  Aust N Z J Med     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  695-8     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Autoimmune Diseases / therapy*
Chronic Disease
Female
Humans
Male
Purpura, Thrombocytopenic / therapy*
Recurrence
Reoperation
Spleen / radionuclide imaging
Splenectomy / adverse effects*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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