Ah. Alsalem et al., SONOGRAPHIC ASSESSMENT OF SPLEEN SIZE IN SAUDI PATIENTS WITH SICKLE-CELL DISEASE, Annals of saudi medicine, 18(3), 1998, pp. 217-220
Background: In patients with SCD, the spleen commonly enlarges during
the first two decades of life but then undergoes autosplenectomy due t
o repeated attacks of vaso-occlusion and infarction. This, however, is
not the case in Saudi patients with SCD, where splenomegaly sometimes
persists into adult life. Patients and Methods: Ultrasonography was u
sed to evaluate spleen size in 363 Saudi patients with SCD (340 SCD an
d 23 sickle beta-thalassemia). A total of 363 patients were evaluated.
Their ages ranged from 1-60 years (mean 16 years).Results: Only 24 (6
.6%) of our patients had autosplenectomy. The splenic index increased
with age until about 40 years of age and then gradually decreased, ind
icating persistence of splenomegaly in our patients into an older age
group. Forty-three patients (11.8%) had marked-massive splenomegaly (s
plenic index > 120 cm(2)) and these had higher HbF levels (mean HbF =
22.2%) when compared with those who had autosplenectomy (mean HbF = 14
.6). This is significant (P-value = 0.0169) and confirms the effect of
HbF on persistence of splenomegaly in SCD patients. Conclusions: Ultr
asonography is a simple, safe and accurate method of assessing splenic
size in patients with sickle cell disease. Patients with persistent s
plenomegaly should be followed closely for development of complication
s which may necessitate splenectomy.