Splenic Size in Sickle Cell Anaemia Patients in A Tertiary Hospital

Abstract

Sickle cell disease is one of the common haemoglobinopathies in the world. It can affect any organ in the body and one of the most common and an early organ to be affected in SCA is the spleen. Reports have shown that patients with sickle cell anaemia (HbSS) have an increased susceptibility to infection leading to increased morbidity and mortality. Autosplenectomy with the consequent absence or reduction of splenic function may explain the propensity to encapsulated bacteria infection. This study was carried out in order to provide an update on the incidence of anatomical autosplenectomy in sickle cell anaemia patients. A comparative cross sectional study of 40 sickle cell anaemia patients in steady state attending Haematology clinic and 40 age and sex-matched healthy HbA control was carried out. An interviewer-administered questionnaire was used to get information on biodata and malaria history. Splenic Ultrasound was done to determine spleen size. Data generated was analyzed using statistical package for social science version 17 (SPSS 17). Twenty (20%) of the sickle cell patients had autosplenectomy (spleen size less than 6cm) while 15% had splenomegaly (spleen size greater than 12cm) and 65% had normal sized spleen(spleen size of 6cm-12cm) on ultrasonography. There was no significance difference (p= 0.332) in the median spleen size of HbS and HbA individuals. Splenic ultrasonography is advocated in determining splenic size in patients with sickle cell anaemia, and could be done annually as a means of monitoring the trend of the size of the spleen in each patient.

Key words: Sickle cell anaemia, Autosplenectomy, Splenomegaly, spleen Ultrasonography