IMMUNOLOGICAL FUNCTION IN POSTTRAUMATIC SPLENOSIS

A 28-year-old male medical student underwent splenectomy at 8 years of age due to traumatic rupture of the spleen sustained in a motor vehic le accident. Eighteen years later the patient had major abdominal surg ery performed for an unrelated condition and, at the time of surgery, over 100 splenic nodules were found embedded throughout the patient's omentum, small bowel, and mesentery. An extensive study of immunologic al functions was carried out during the following 2 years. Through the course of this investigation, it was determined that the patient's pe ripheral blood smear lacked Howell-Jolly bodies and deformed or damage d erythrocytes, indicating that the splenotic tissue had the capacity to remove intranuclear inclusions from circulating red cells and to ph agocytose old erythrocytes. The patient's levels of complement, serum immunoglobulins and the numbers of circulating T and B lymphocytes, he lper T cells, and cytotoxic/suppressor T cells all were within the nor mal range. The response to Streptococcus pneumoniae polysaccharides wa s also normal, with increased levels of specific antibodies to all ser otypes included in the vaccine 4 months after immunization. Finally, h istological examination of his biopsied splenotic nodules revealed tis sue that was indistinguishable from normal spleen. (C) 1995 Academic P ress, Inc.