Splenic Infarction after Epstein-Barr Virus Infection in a Patient with Hereditary Spherocytosis

  • Yuhko Suzuki
  • Tsutomu Shichishima
  • Miyuki Mukae
  • Manabu Ohsaka
  • Miyuki Hayama
  • Ryouichi Horie
  • Tomiteru Togano
  • Koji Miyazaki
  • Masaaki Ichinoe
  • Keiichi Iwabuchi
  • Hisaichi Fujii
  • Masaaki Higashihara
Case report

Abstract

We describe the first patient with hereditary spherocytosis (HS) known to have developed splenic infarction following infectious mononucleosis (IM). An 18-year-old Japanese man was referred to our hospital in November 2004 because of continuous fever and icterus. He had undergone cholecystectomy at the age of 14 years. On patient admission in November 2004, a physical examination showed marked hepatosplenomegaly, icterus, and jaundice. He had a white blood cell count of 14.9 x 109/L with 9.5% atypical lymphocytes, a red blood cell count of 2.93 x 1012/L, and a hemoglobin concentration of 7.8 g/dL. Microspherocytes were observed in the patient’s peripheral blood smear, and immunoglobulin M antibody to Epstein-Barr virus (EBV) viral capsid antigen was detected. The patient’s diagnosis was HS with IM. On day 4 of admission, the patient complained of severe abdominal pain. Abdominal computed tomography scanning revealed findings of splenic infarction.Two months after the occurrence of splenic infarction, a splenectomy was performed. A pathohistologic examination of the resected spleen revealed no evidence of thrombosis or arterial occlusion. We assume that the cause of splenic infarction was insufficient blood flow to oxygenate the entire spleen during the acute enlargement of the spleen.

Key words

Splenic infarction Hereditary spherocytosis Epstein-Barr virus 

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Copyright information

© The Japanese Society of Hematology 2007

Authors and Affiliations

  • Yuhko Suzuki
    • 1
  • Tsutomu Shichishima
    • 2
  • Miyuki Mukae
    • 1
  • Manabu Ohsaka
    • 1
  • Miyuki Hayama
    • 1
  • Ryouichi Horie
    • 1
  • Tomiteru Togano
    • 1
  • Koji Miyazaki
    • 1
  • Masaaki Ichinoe
    • 3
  • Keiichi Iwabuchi
    • 3
  • Hisaichi Fujii
    • 4
  • Masaaki Higashihara
    • 1
  1. 1.Department of HematologyKitasato University School of MedicineSagamiharaJapan
  2. 2.First Department of Internal MedicineFukushima Medical UniversityFukushimaJapan
  3. 3.Department of Clinical PathologyKitasato University School of MedicineSagamiharaJapan
  4. 4.Department of Transfusion Medicine and Cell ProcessingTokyo Women’s Medical UniversityTokyoJapan
  5. 5.Sagamihara, KanagawaJapan

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