Comparative sonographic assessment of the spleen in individuals with and without sickle cell anaemia in Abakaliki, Nigeria

Abstract

Background: Sickle cell anaemia (HbSS) is a major public health problem in Sub-Saharan Africa and commonly affects the spleen, with associated increased morbidity and mortality. This study aimed to evaluate the ultrasonographic findings of the spleen in patients with HbSS in steady state and to compare findings with those of individuals with normal adult haemoglobin (HbAA).

Methods: This was a cross-sectional comparative study. Haemoglobin phenotypes were determined using haemoglobin electrophoresis. The spleen was scanned using transabdominal ultrasonography. Splenic size and parenchymal echotexture were assessed. Data was analysed with SPSS software, version 20.

Results: One-hundred-and-twenty participants were recruited for the study, made up of 60 patients with HbSS and 60 age-and-sex-matched individuals with HbAA. They were made up of 54 (45%) males and 66 (55%) females, aged 2 to 32years, with mean age of 15.78 ±7.2 years for HbSS and 15.80 ±7.5years for HbAA participants. Thirteen (21.7%) patients with HbSS had autosplenectomy, 7 (11.7%) had splenomegaly, 6 (10%) had shrunken spleens, while 34 (56.7%) had normal sized spleens. All the participants with HbAA had normal splenic size with age. Of the 47 patients with HbSS whose spleen were visualized, 20 (42.6%) had abnormal splenic echotexture, whereas all the 60 (100%) participants with HbAA, had normal echotexture. There was significant difference in splenic echotexture in patients with HbSS compared to those with HbAA (p <0.05).

Conclusion: A number of patients with HbSS have abnormal splenic size and echotexture compared to those with HbAA. There should be adequate follow up of patients with HbSS to prevent possible resultant splenic complications.