Overview
The roles of the spleen are to filter the blood to remove old and damaged blood cells, create new blood cells, and store platelets. It plays a key role in the body’s immune system. The spleen consists of white pulp and red pulp:
- White pulp:
- Contains B- and T-lymphocytes that recognise and attack pathogens
- Red pulp:
- Removes old and damaged red blood cells
- Stores platelets
- Produces new red blood cells in foetuses – this stops after birth
Hyposplenism
Hyposplenism describes a reduction in spleen function. This can be due to:
- Sickle cell anaemia
- Thalassaemia
- Lymphoma
- Leukaemia
- Coeliac disease
- Ulcerative colitis
- Essential thrombocytosis
Blood films usually show Howell-Jolly bodies in hyposplenism. They may also show Pappenheimer bodies and target cells.
Complications
Since the spleen plays a role in the immune system, complications may be:
- Severe infection due to encapsulated bacteria, the most common being Streptococcus pneumoniae, followed by Haemophilus influenzae type b (Hib) and Neisseria meningitidis.
- Severe infection to malaria
Management
All patients
- 1st-line: immunisations + antibiotic prophylaxis:
- 5-yearly pneumococcal vaccinations
- Antibiotics used are oral phenoxymethylpenicillin or erythromycin
