Postsplenectomy course in homozygous sickle cell disease
J Pediatr
; 134(3): 304-9, Mar. 1999.
Article
in English
| MedCarib
| ID: med-1405
Responsible library:
JM3.1
Localization: JM3.1; RJ1.J6
ABSTRACT
OBJECTIVE:
To determine whether children with homozygous sickle cell (SS) disease and splenectomy are at greater risk of death, overwhelming septicemia, or other complications.METHODS:
A total of 130 patients with SS treated by splenectomy (46 recurrent acute splenic sequestration, 84 chronic hypersplenism) over a 22.5-year period at the Sickle Cell Clinic of the University Hospital of the West Indies, Kingston, Jamaica, were compared with a control group matched for sex, age, and duration of follow-up in a retrospective review. Deaths and bacteremias were examined over the whole study period. Painful crises, acute chest syndromes, and febrile episodes were compared in the 90 patients completing 5 years of postsplenectomy follow-up.FINDINGS:
Mortality and bacteremic episodes did not differ between the splenectomy and control groups. Painful crises were more common in the splenectomy group than in the control group (P = .01) but did not differ between splenectomy indications. Acute chest syndrome was more common in the splenectomy group than in the control group (P < .01) and was more common in the acute splenic sequestration group than in the hypersplenism group (P = .01). Febrile events did not differ between the groups or between the indications for splenectomy.CONCLUSION:
Splenectomy does not increase the risk of death or bacteremic illness in patients with SS disease and, if otherwise indicated, should not be deferred for these reasons (Au)
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Collection:
International databases
Health context:
SDG3 - Health and Well-Being
/
SDG3 - Target 3.3 End transmission of communicable diseases
/
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
/
SDG3 - Target 3.2 Reduce avoidable death in newborns and children under 5
Health problem:
Target 3.2: Reduce avoidable death in newborns and children under 5
/
Sepsis
/
Sickle Cell Disorders
/
Noncommunicable Diseases
Database:
MedCarib
Main subject:
Splenectomy
/
Homozygote
/
Anemia, Sickle Cell
Type of study:
Etiology study
/
Observational study
/
Prognostic study
/
Risk factors
Limits:
Adolescent
/
Adult
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Country/Region as subject:
English Caribbean
/
Jamaica
Language:
English
Journal:
J Pediatr
Year:
1999
Document type:
Article