Wright, J.G., Hambleton, I.R., Thomas, P., Duncan, N.D., Venugopal, S. and Serjeant, G.R., 1999. Postsplenectomy course in homozygous sickle cell disease. The Journal of Pediatrics, 134 (3), pp. 304-309.
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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.
|Subjects:||Technology > Medicine and Health|
|Group:||School of Health and Social Care > Centre for Social Work and Social Policy|
|Deposited By:||Mr Adam Field|
|Deposited On:||12 Oct 2007|
|Last Modified:||07 Mar 2013 14:44|
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