Autoimmune hemolytic anemia surgery: Difference between revisions
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==Surgery== | ==Surgery== | ||
===[[Splenectomy]]=== | |||
Splenectomy, or removal of the spleen, is a second-line option for autoimmune hemolytic anemia. Splenectomy is frequently considered for patients who have steroid-refractory or relapsed disease. The response rate for splenectomy is typically 66%.<ref name="pmid25271314">{{cite journal| author=Zanella A, Barcellini W| title=Treatment of autoimmune hemolytic anemias. | journal=Haematologica | year= 2014 | volume= 99 | issue= 10 | pages= 1547-54 | pmid=25271314 | doi=10.3324/haematol.2014.114561 | pmc=4181250 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25271314 }} </ref> The ideal candidate for splenectomy is one who has adequate functional status and cardiopulmonary reserve to undergo surgery. The decision to proceed with splenectomy is typically made jointly between the patient and physician, as surgical intervention carries inherent risks. Given the infectious risk for splenectomy, patients should undergo vaccination for ''Hemophilus influenzae'', ''Neisseria meningitides'', and ''Streptococcus pneumoniae.'' The three organisms are encapsulated bacteria which are normally eliminated by the spleen via complement-mediated opsonization. | |||
**''Adverse effects'': The adverse effects of splenectomy include the inherent surgical risk, bleeding, post-operative thrombosis, post-operative pain, systemic infection (asplenic sepsis) with encapsulated organisms, and reactive thrombocytosis. | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 01:10, 18 March 2018
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Overview
Surgery
Splenectomy
Splenectomy, or removal of the spleen, is a second-line option for autoimmune hemolytic anemia. Splenectomy is frequently considered for patients who have steroid-refractory or relapsed disease. The response rate for splenectomy is typically 66%.[1] The ideal candidate for splenectomy is one who has adequate functional status and cardiopulmonary reserve to undergo surgery. The decision to proceed with splenectomy is typically made jointly between the patient and physician, as surgical intervention carries inherent risks. Given the infectious risk for splenectomy, patients should undergo vaccination for Hemophilus influenzae, Neisseria meningitides, and Streptococcus pneumoniae. The three organisms are encapsulated bacteria which are normally eliminated by the spleen via complement-mediated opsonization.
- Adverse effects: The adverse effects of splenectomy include the inherent surgical risk, bleeding, post-operative thrombosis, post-operative pain, systemic infection (asplenic sepsis) with encapsulated organisms, and reactive thrombocytosis.
References
- ↑ Zanella A, Barcellini W (2014). "Treatment of autoimmune hemolytic anemias". Haematologica. 99 (10): 1547–54. doi:10.3324/haematol.2014.114561. PMC 4181250. PMID 25271314.