Reactive Thrombocytosis after Splenectomy in Hereditary Spherocytosis: Case Report and Literature Review
  • Chidinma Ejikeme
    Internal Medicine Departent, Rutgers-New Jersey Medical School/ Trinitas Regional Medical Center. Elizabeth, NJ, USA
  • Sherif Elkattawy
    Internal Medicine Departent, Rutgers-New Jersey Medical School/ Trinitas Regional Medical Center. Elizabeth, NJ, USA
  • Fisayo Kayode-Ajala
    Internal Medicine Departent, Rutgers-New Jersey Medical School/ Trinitas Regional Medical Center. Elizabeth, NJ, USA
  • Sarah Ayad
    Internal Medicine Departent, Rutgers-New Jersey Medical School/ Trinitas Regional Medical Center. Elizabeth, NJ, USA
  • Abraheim Al-nasseri
    St. George’s University, West Indies, Grenada
  • William Kessler
    Department of Hematology and Oncology, Trinitas Regional Medical Center. Elizabeth, NJ, USA

Keywords

Thrombocytosis, splenomegaly, hereditary spherocytosis, thrombosis, hypercoagulable

Abstract

Reactive thrombocytosis after splenectomy is a feared cause of thrombosis throughout the arterial and venous system. There are many causes of splenomegaly, ranging from cirrhosis to lymphoma to hereditary spherocytosis. In this report, we will discuss a case of reactive thrombocytosis after splenectomy in a patient with hereditary spherocytosis. Splenomegaly is a relatively common finding in HD patients, causing extravascular haemolysis and thus leading to haemolytic anaemia. Splenectomy is usually considered when patients start to manifest severe symptoms such as abdominal pain, jaundice or worsening liver function tests. Our patient was a good surgical candidate and successfully underwent splenectomy but afterwards developed arterial and venous thrombosis due to reactive thrombocytosis. An extensive hypercoagulable work-up was unremarkable. The patient was started on hydroxyurea and anticoagulation with eventual improvement of platelet levels.

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References

  • Kimmig LM, Palevsky HI. Review of the association between splenectomy and chronic thromboembolic pulmonary hypertension. Ann Am Thorac Soc 2016;13:945–954. doi: 10.1513/AnnalsATS.201512-826FR. PMID: 27058013
  • Boxer MA, Braun J, Ellman L. Thromboembolic risk of postsplenectomy thrombocytosis. Arch Surg1978;113:808–809. doi: 10.1001/archsurg.1978.01370190030004
  • Stamou KM, Toutouzas KG, Kekis PB, Nakos S, Gafou A, Manouras A, et al. Prospective study of the incidence and risk factors of postsplenectomy thrombosis of the portal, mesenteric, and splenic veins. Arch Surg 2006;141:663–669. doi: 10.1001/archsurg.141.7.663. PMID: 16847237.
  • Chiarello P, Magnolia M, Rubino M, Liguori SA, Miniero R. Thrombocytosis in children. Minerva Pediatr 2011;63:507–513.
  • Yadav D, Chandra J, Sharma S, Singh V. Clinicohematological study of thrombocytosis. Indian J Pediatr 2010;77:643–647. doi: 10.1007/s12098-010-0091
  • Sarbay H, Akbayram S. Secondary severe thrombocytosis in a patient who underwent splenectomy due to hereditary spherocytosis and its treatment using hydroxyurea. Pan Afr Med J 2019;32:175. doi: 10.11604/pamj.2019.32.175.17841
  • Greer JP, Foerster J, Lukens JN, Rodgers GM, Paraskevas F, Glader B, editors. Wintrobe's Clinical Hematology. 11th ed. Philadelphia: Lippincott Williams & Wilkins; 1981. pp. 1128–1134.
  • Mentzer WC. Hereditary spherocytosis. UpToDate 2021.
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    Published: 2021-07-06
    Issue: 2021: Vol 8 No 7 (view)


    How to cite:
    1.
    Ejikeme C, Elkattawy S, Kayode-Ajala F, Ayad S, Al-nasseri A, Kessler W. Reactive Thrombocytosis after Splenectomy in Hereditary Spherocytosis: Case Report and Literature Review. EJCRIM 2021;8 doi:10.12890/2021_002673.

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