Accessory spleen in recurrent chronic immune thrombocytopenic purpura

From 1969 to 1985 we discovered accessory spleens in 8 patients with chronic immune thrombocytopenic purpura (ITP) who relapsed or failed after splenectomy. Imaging of accessory spleen used a liver spleen scintigraphy with heat‐treated RBC labeled with Tc‐99m. Platelet kinetic studies with 51Cr or 111In, including sequestration index, were performed. Five patients had accessory splenectomy. Disappearance of bleeding symptoms was achieved in the 5 splenectomized patients but with only partial response of platelet counts. These results are discussed in the context of diagnosis and therapeutic management of accessory spleens in patients with chronic immune thrombocytopenic purpura who relapsed or failed afler splenectomy. © 1992 Wiley‐Liss, Inc.

[1]  P. Fenaux,et al.  INTERFERON ALPHA‐2b THERAPY IN REFRACTORY ADULT CHRONIC THROMBOCYTOPENIC PURPURA , 1991, British journal of haematology.

[2]  A. Sézeur,et al.  [Value of peroperative scintigraphy in detecting accessory spleens]. , 1990, Presse medicale.

[3]  P. Fenaux,et al.  Re‐evaluation of the role of azathioprine in the treatment of adult chronic idiopathic thrombocytopenic purpura: a report on 53 cases , 1990, British journal of haematology.

[4]  R. Beuscart,et al.  Reevaluation of the prognostic factors for splenectomy in chronic idiopathic thrombocytopenic purpura (ITP): A report on 181 cases , 1989, European journal of haematology.

[5]  R. Coleman,et al.  Splenectomy for Primary and Recurrent Immune Thrombocytopenic Purpura (ITP): Current Criteria for Patient Selection and Results , 1987, Annals of surgery.

[6]  J. Järhult,et al.  Accessory spleen imaging. Radionuclide, ultrasound and CT investigations in a patient with thrombocytopenia 25 yr after splenectomy for ITP. , 2009, Scandinavian journal of haematology.

[7]  H. Kronenberg,et al.  Management of splenectomy failures in chronic immune thrombocytopenic purpura: role of accessory splenectomy. , 1986, Australian and New Zealand journal of medicine.

[8]  A. Avilés,et al.  Accessory spleen compromising response to splenectomy for idiopathic thrombocytopenic purpura. , 1985, Radiology.

[9]  S. Horii,et al.  Sonography of the accessory spleen. , 1984, AJR. American journal of roentgenology.

[10]  R. Mylvaganam,et al.  Slow infusion of vinca alkaloids in the treatment of idiopathic thrombocytopenic purpura. , 1984, Annals of internal medicine.

[11]  D. Fromm,et al.  Accessory splenectomy for idiopathic thrombocytopenic purpura. , 1982, Surgery.

[12]  M. Baccarani,et al.  Chronic idiopathic thrombocytopenic purpura (ITP): site of platelet sequestration and results of splenectomy. A study of 197 patients. , 2009, Scandinavian journal of haematology.

[13]  H. Wahner,et al.  Idiopathic Thrombocytopenic Purpura: Detection of Accessory Splenic Tissue , 1981, Clinical nuclear medicine.

[14]  A. Gottlieb,et al.  Adult idiopathic thrombocytopenic purpura. Clinical findings and response to therapy. , 1980, The American journal of medicine.

[15]  A. Varki,et al.  Detection of accessory spleens with indium 111‐labeled autologous platelets , 1980, American journal of hematology.

[16]  B. Forget,et al.  Idiopathic thrombocytopenic purpura occurring in a subject previously splenectomized for traumatic splenic rupture. Role of splenosis in the pathogenesis of thrombocytopenia. , 1978, The American journal of medicine.

[17]  Clifton,et al.  Accessory splenectomy in management of recurrent idiopathic thrombocytopenic purpura. , 1978, Mayo Clinic proceedings.

[18]  M. Welch,et al.  Indium-LLL labeled platelets: studies on preparation and evaluation of in vitro and in vivo functions. , 1976, Thrombosis research.

[19]  J. Lewis,et al.  Splenunculectomy in recurrent thrombocytopenia. , 1976, Acta haematologica.

[20]  J. Wainscoat,et al.  Recurrent thrombocytopenic purpura associated with accessory spleen. , 1976, Archives of disease in childhood.

[21]  R. Gobin,et al.  Technetium-99m labeling by means of stannous pyrophosphate: application to bleomycin and red blood cells. , 1975, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[22]  R. P. Spencer,et al.  Recurrent idiopathic thrombocytopenia purpura with "accessory" splenic tissue. , 1975, Pediatrics.

[23]  Y. Ahn,et al.  Vincristine therapy of idiopathic and secondary thrombocytopenias. , 1974, The New England journal of medicine.

[24]  N. Ardaillou,et al.  The Sequestration Site of Platelets in Idiopathic Thrombocytopenic Purpura: its Correlation with the Results of Splenectomy , 1971, British journal of haematology.

[25]  B. Bouroncle,et al.  IDIOPATHIC AND SECONDARY THROMBOCYTOPENIC PURPURA: CLINICAL STUDY AND EVALUATION OF 381 CASES OVER A PERIOD OF 28 YEARS , 1960 .

[26]  P. Thorek,et al.  Recurrent Primary Thrombocytopenic Purpura with Accessory Spleens: Review of the Literature. , 1948, Annals of surgery.

[27]  M. Lederer,et al.  ACCESSORY SPLEENS—THEIR SIGNIFICANCE IN ESSENTIAL THROMBOCYTOPENIC PURPURA HEMORRHAGICA , 1928 .

[28]  Morrison.  A Further Discussion of College Mental Hygiene , 1928 .