SPLENIC SIZE DETERMINATION IN SICKLE CELL ANAEMIA: AN ULTRASONOGRAPHIC STUDY

Abstract

Objectives: To examine the generally accepted concept of autospk nectomy in patients with
sickle ceil anaemia, and determine the relationship between age, I he 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 Deparc ment for minor ailments.
Interventions: Longitudinal and coronal sizes of the spleen were n reasured antemortem, by
ultrasonographic method, in 98 adult sickle cell anaemia patients a1 rd 48 control subjects and
compared. The splenic sue was correlated with age and PCV alnong sickle cell anaemia
patients.
Main outcome measures: Determination of longitudinal and co~onal 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 sues.
Results: Both mean longitudinal and coronal diameters, and surf: Ice 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 c ecreased 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 parients suffer anatomical
autosplenectomy was not confirmed. This could be due to the effect of malaria and improved
clinical care.