From the Guidelines
A history of splenectomy typically does not cause anemia but does lead to elevated platelet counts (thrombocytosis). After splenectomy, platelet counts commonly rise due to the removal of the spleen, which normally sequesters and destroys about one-third of circulating platelets. This elevation usually begins within days after surgery and may persist indefinitely, though it often moderates over time [@\1@]. Rather than causing anemia, splenectomy can actually improve certain types of anemia, particularly those where the spleen was destroying red blood cells prematurely. However, patients with a history of splenectomy are at increased risk for certain infections due to reduced immune function and should receive appropriate vaccinations against encapsulated organisms. Some key points to consider in the management of post-splenectomy patients include:
- Monitoring for thrombotic complications that can result from persistent thrombocytosis [@\1@]
- Providing appropriate vaccinations against encapsulated organisms to reduce the risk of infection
- Periodic assessment for signs of anemia or other hematologic abnormalities, though anemia is not typically a direct result of splenectomy
- Considering the guidelines for the treatment of immune thrombocytopenia (ITP) after splenectomy, which recommend against further treatment in asymptomatic patients with platelet counts > 30 x 10^9/L [@\1@]
From the Research
History of Splenectomy and Its Effects on Blood Parameters
- A history of splenectomy can lead to changes in blood parameters, including platelet count and hemoglobin levels 1, 2, 3, 4, 5.
- Studies have shown that splenectomy often results in reactive thrombocytosis, which is a condition characterized by an elevated platelet count 1, 2, 3, 4.
- The incidence of thrombocytosis after splenectomy can be as high as 75-82% 2, and it is more likely to occur after splenectomy compared to spleen-preserving strategies 3.
Relationship Between Splenectomy and Anemia
- There is evidence to suggest that anemia may be related to persistent post-splenectomy thrombocytosis, with a significant negative correlation between hemoglobin level and platelet count observed in one study 5.
- However, the exact relationship between splenectomy and anemia is not fully understood and requires further research.
Effects of Splenectomy on Platelet Count
- Splenectomy can lead to an increase in platelet count, with some studies showing that the platelet count can peak after total splenectomy 3.
- The elevated platelet count after splenectomy can increase the risk of thrombotic events, such as acute myocardial infarction, mesenteric vein thrombosis, and pulmonary embolism 1, 2, 3, 4.
- However, not all patients with elevated platelet counts after splenectomy will develop thrombotic events, and the risk of thrombosis is still being studied 1, 2, 3, 4.