Effect of splenectomy on blood picture in Children with thalassemia major

Abstract EN

Background: Beta thalassemias are a group of inherited autosomal recessive hematological disorders, it results in red blood cell destruction with symptoms of anemia.

Red blood cell destruction, repeated blood transfusion and bad compliance to routine use of iron chelator lead to iron accumulation in the heart, liver and endocrine organs, Clinical picture of this disease is microcytosis and hemolytic anemia that need repeated blood transfusion which may lead to irreversible damage to organs and tissues due to iron accumulation, about 90% of patients with thalassemia had undergone splenectomy by age 15 years with a result in stoppage of transfusion requirement in most thalassemia intermedia patients and with a decrease in the need for red cell transfusions in thalassemia major patients.

Aim of study: To study the effect of splenectomy on different blood picture parameters in children with β- Thalassemia Major.

Methods: A prospective study that was conducted on 40 confirmed homozygous β- thalassemia major patients before and after splenectomy with complete physical examination was performed for all patients by assessing anthropometric measurements, vital signs, presence of pallor, jaundice, liver status.

Complete blood picture with blood indices by Coulter Counter in addition to reticulocytes count.

Results: After splenectomy there is higher mean level of hemoglobin with 5.3% increase, higher platelet count with 110% rise in the mean platelet count and higher total leucocytic count with 42.5% increase and decreased reticulocytic count with a drop of 41% in the mean level of reticulocytes with all results statistically highly significant.

Conclusion: There is improvement of blood picture parameters after splenectomy which includes increasing of hemoglobin level and platelet count with decreased level of reticulocytic count.

The increase of total leucocytic count after splenectomy is explained by the increased rate of infection.