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Forum Name: Gastroenterology Topics

Question: Spleen Enlargement and removal


 sethikapil - Tue Jun 22, 2004 5:03 am

Hi,

My dad has been advised for spleenectomy. I am confused wether to go for it or not. Spleen is massively enlarged. His RBC survival test shows hypersplenism. His platlet count is around 90000, RBC count 3000, Hb 8.7, Bilrubin 2.7.
Coombs test shows DCT +ve and ICT weak +ve. Malaria, Hams test, HPLC test are -ve. No Liver cirrosis. Bone marrow test doesnt show anythg wrong.
Retic Count< 1.
Please advice should i go for any other test to detect some infection. Should i go for any medication of hemolytic anemia. Should i go for spleenectomy.
Thanks.
Kapil
 Dr. Tamer Fouad - Tue Jun 22, 2004 11:10 am

User avatar Dear sethikapil,
Have you been to a hematologist? Hypersplenism is usually secondary to another disease; only rarely is the cause of hypersplenism not known (primary hypersplenism). I think you should spend a little more time trying to find the cause.

Is the bone marrow test a biopsy or an aspirate? It seems strange that in the wake of hypersplenism that the bone marrow is not producing enough reticulocytes to compensate for the rapid loss of RBCs.

Have a look at this page to get a clearer picture of the interaction between anemia, bone marrow and spleen:
anemia/" class="postlink">Click here!
Another finding is the positive Coomb's test which suggests an immune process.
 sethikapil - Sun Jun 27, 2004 7:12 am

Hi Doctor,

Thanks for the reply.
Yes I am also consulting a haematologist. Both bone marrow aspirate and biopsy are ok. Recently Retic count was tested again. It came out to be 4. So that means bone marrow is ok. But Coombs test and hypersplenism both are coming +ve. Coombs test coming +ve (inspite of that my father has never been on blood).Regarding hypersplenism there was some confusion. Initially this test was given –ve and then it was given +ve. Is there any other test other than RBC survival test, which can confirm the hypersplenism. My father’s age is 63. Also could you tell me some site on which I can post my queries to haematologist.

Rgds
Kapil

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