Splenic size determination in sickle cell anaemia: An ultrasonographic study

Abstract

Objectives: To examine the generally accepted concept of autosplenectomy in patients with sickle cell anaemia, and determine the relationship between age, the steady state PCV and splenic size. Design: Case - control study. Setting: Sickle Cell Clinic, University of Ilorin Teaching Hospital, Ilorin, Nigeria. Subjects: Sickle cell anaemia patients aged three to 47 years, while the controls included age and sex matched patients attending the General Outpatient Department for minor ailments. Interventions: Longitudinal and coronal sizes of the spleen were measured antemortem, by ultrasonographic method, in 98 adult sickle cell anaemia patients and 48 control subjects and compared. The splenic size was correlated with age and PCV among sickle cell anaemia patients. Main outcome measures: Determination of longitudinal and coronal sizes of the spleen, comparison of mean splenic sizes of patients with those of controls by Student's t test, and correlation of age and PCV with splenic sizes. Results: Both mean longitudinal and coronal diameters, and surface area were found to be higher in the sickle cell anaemia patients compared to the controls. While the longitudinal diameter increased with age continuously, the coronal diameter decreased after the age of 30 years. There were no significant correlations between the splenic sizes and PCV and number of crises per year. Conclusion: The general belief that sickle cell anaemia patients suffer anatomical autospienectomy was not confirmed. This could be due to the effect of malaria and improved clinical care.