Summary
The effects of splenectomy in the treatment of chronic idiopathic thrombocytopenic purpura (ITP) were analysed in 177 subjects (118 adults and 59 children) operated upon between two and 25 years earlier.
In 145 patients, thrombocytopenia regressed immediately or within 2 months after the operation. Regression of thrombocytopenia later during follow up was observed in a further 14 cases.
Recurrence of thrombocytopenia after good immediate result of splenectomy developed in 32 patients. In 13 cases the recurrence was transient but in the remaining 19 patients it was long-lasting. In these cases presence of accessory spleens was suggested by the absence of Howell-Jolly bodies in the peripheral blood smear and demonstrated by splenic scan in 16 cases, and confirmed in 13 out of 15 splenectomized patients. Resplenectomy caused in 12 patients permanent disappearance of thrombocytopenia.
Similar content being viewed by others
References
Appel MF, Bart JB (1973) The surgical and hematologic singnificance of accessory spleens. Surg Gynecol Obstet 143: 191
Brewster DC (1973) Splenosis. Report of two cases and review of the literature. Am J Surg 126: 14
Burger T, Schmelczer K, Kett K, Kutas J (1978) Immune thrombocytolytic purpura (ITP): A diagnostic and therapeutic survey of 86 cases with regard to the results of splenectomy and conservative therapy. Acta Med Acad Sci Hung 35: 213
Colombetti LG, Goodwin DA, Hermanson R (1969) Indium 113m-labelled compound for liver and spleen studies. J Nucl Med 10: 597
Davis HH, Varki A, Heaton A, Siegel BA (1980) Detection of accessory spleens with indium 111-labeled autologous platelets. Am J Hematol 8: 81
Eckelman W, Richards P, Hauser W, Atkins H (1971) Technetium labelled red blood cells. J Nucl Med 12: 22
Fabri PJ, Metz EN, Nick WV, Zollinger RM (1974) A quarter century with splenectomy. Changing concepts. Arch Surg 108: 569
Fleming CR, Dickson ER, Harrison EG (1976) Splenosis. Autotransplantation of splenic tissue. Am J Med 61: 414
Fontein DL, Woldring MC, Nieweg HD 1969) Management of idiopathic thrombocytopoenic purpura. Br J Haematol 17: 301 (Abstract)
Gruenberg J (1980) Splenectomy for thrombocytopenia (discussion). Surgery 88: 505
Hann IM, Wainscoat JS (1976) Recurrent thrombocytopenic purpura associated with accessory spleen. Arch Dis Child 51: 154
Jacobson SJ, De Narc G (1971) Splenosis demonstrated by splenic SCA. J Nucl Med 12: 570
Jiji RM, Firozvi T, Spurling CL (1973) Chronic idiopathic thrombocytopenic purpura. Treatment with steroids and splenectomy. Arch Intern Med 132: 380
Mackie WJ, Miller DF (1973) Splenosis. A case report and some considerations on the function of splenotic tissue. Br J Surg 60: 56
MacPherson AIS, Richmond J (1975) Planned splenectomy in treatment of idiopathic thrombocytopenic purpura. Br Med J 5949: 64
Mazur EM, Field WW, Cohow CE, Schiffman FJ, Duffy TP, Forget BG (1978) Idiopathic thrombocytopenic purpura occuring in a subject previously splenectomized for traumatic splenic rupture. Role of splenosis in the pathogenesis of thrombocytopenia. Am J med 65: 843
Najean Y, Ardaillou N (1971) The sequestration site of platelets in idiopathic thrombocytopenic purpura: its correlation with the results of splenectomy. Br J Haematol 21: 153
Nordey A, Neset G (1968) Splenectomy in hematologic diseases. Acta Med Scand 183: 117
Pawelski S, Rudowski W, Rechowicz K, Zdziechowska H, Konopka L, Kotelba-Witkowska B, Klawe Z, Nowak S (1971) The effect of splenectomy on the survival time of platelets in thrombocytopenia. Folia Haematol (Leipzig) 95: 304
Pawelski S, Konopka L, Zdziechowska H (1978) Wznowy krwotoczności u osób poddanych splenektomii z powodu samoistnej małopłytkowj skazy krwotocznej. Pol Tyg Lek 33: 221
Pawelski S, Konopka L, Rechowicz K (1972) Diagnostyka Izotopowa w Hematologii. PZWL, Warszawa
Rokicka R, Milewska R, Rechowicz K, Konopka L, Derulska D, Kozłowska J, Kotelba-Witkowska B, Kamiński W, Pawelski S (1978) Odległe wyniki splenektomii w przewlekłej samoistnej skazie małopłytkowej u dzieci. Pediatr Pol 53: 297
Roy M, Marks Ch (1971) Splenectomy. A study of indications and sequelae. Ohio State Med J 67: 1983
Rudowski WJ (1977) Disorders of hemostasis in surgery, 1st edn. The University Press of New England. Hannover New Hampshire
Schwartz SI, Hoep LM, Sachs S (1980) Splenectomy for thrombocytopenia. Surgery 88: 497
Schwartz SI, Adams JT, Bauman AW (1971) Splenectomy for hematologic disorders. Curr Probl Surg 28: 1
Spero JA, Lewis JH, Hasiba V, Gumerman LW (1976) Splenunculectomy in recurrent thrombocytopenia. Acta Haematol 55: 354
Verheyden ChN, Beart RW, Clifton MD, Phyliky RL (1978) Accessory splenectomy in management of recurrent idiopathic thrombocytopenic purpura. Mayo Clin Proc 53: 442
Walker W (1976) Splenectomy in childhood: a review in England and Wales, 1960–1964. Br J Surg 63: 36
Walewska I (1977) Metody badań w immunohematologii krwinek płytkowych (rozdz.) w Diagnostyka Laboratoryjna w Hematologii, pod red. S. Pawelski. PZWL, Warszawa
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Pawelski, S., Konopka, L. & Zdziechowska, H. Recurrence of thrombocytopenia in patients splenectomized for idiopathic thrombocytopenic purpura. Blut 43, 355–360 (1981). https://doi.org/10.1007/BF00320313
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00320313