Accessory spleens after splenectomy in a patient with common variable immunodeficiency

Blood cells are mainly destroyed in the spleen during autoimmune cytopenia. Amongst the various therapeutic strategies, splenectomy is sometimes necessary during the disease course. However, splenosis or accessory spleens can account for autoimmune cytopenia relapse after initial splenectomy in thes...

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Bibliographic Details
Published in:La revue de medecine interne 2010-01, Vol.31 (1), p.41-45
Main Authors: Georgin-Lavialle, S, Gossot, D, Galicier, L, Oksenhendler, E, Fieschi, C
Format: Article
Language:fre
Subjects:
Adolescent
Common Variable Immunodeficiency - complications
Humans
Male
Recurrence
Spleen - abnormalities
Splenectomy - adverse effects
Thrombocytopenia - immunology
Thrombocytopenia - surgery
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Summary:Blood cells are mainly destroyed in the spleen during autoimmune cytopenia. Amongst the various therapeutic strategies, splenectomy is sometimes necessary during the disease course. However, splenosis or accessory spleens can account for autoimmune cytopenia relapse after initial splenectomy in these patients. We report an 18-year-old male with common variable immunodeficiency who presented with immunological thrombocytopenia. Splenectomy allowed remission of cytopenia, but a relapse was attributed to splenosis, because Jolly bodies were absent on blood smear. Laparoscopic splenectomy of accessory spleens induced long term remission. A literature review is performed. Fifteen to 20% of relapses of autoimmune cytopenia treated by splenectomy are related to accessory spleens. Ablation of accessory spleens can cure again the patients, including patients with accompanying common variable immunodeficiency.
ISSN:1768-3122
DOI:10.1016/j.revmed.2009.06.006