Autosplenectomy of Sickle Cell Disease in Zaria, Nigeria: An Ultrasonographic Assessment

• Main Authors: Mohammed Sirajo Aminu, J Aiyekomogbon, Ifeoma P Ijei, Rasheed Yusuf, Abdulaziz Hassan, Philip Ibinaye, Aliyu Ahmadu Babadoko, A.U Hamidu
• Format: Article
• Language: English
• Published: Oman Medical Specialty Board 2012-03-01
• Series: Oman Medical Journal
• Subjects: sickle cell anemia; Autosplenectomy; Ultrasonography
• Online Access: http://journals.indexcopernicus.com/fulltxt.php?ICID=989888
• ISSN: 1999-768X; 2070-5204

 Objectives: During infancy and early childhood, the spleencommonly enlarges in patients with sickle cell anemia (SCA), and it thereafter undergoes progressive atrophy due to repeated episodes of vaso-occlusion and infarction, leading to autosplenectomy in adult life. However, this may not always be the case as some studies have reported splenomegaly persisting into adult life. This study aims to determine and review the prevalence of autosplenectomy by abdominal ultrasonography in sickle cell anemic patients in Zaria, Nigeria.Methods: An ex-post-facto cross study of 74 subjects was carried out between May to July in 2010. Hematological parameters were determined by an analyzer while B mode Ultrasonography was used to determine the craniocaudal length of the spleen, if visualized.Results: The mean age of the sickle cell subjects was 23.2 ±5.3 years, while that of the controls was 22.7±12.4 years. Of the 74 sickle cell subjects, 55.4�0were females; while of the 20 controls,50�0were females. Forty one subjects (55.4�20had autosplenectomy and a significant difference existed in the mean splenic size compared with the control (p<0.0001). Only 3 (4.05�20subjects had splenomegaly, while 23 (31�20had a shrunken spleen.Conclusion: Anatomical autosplenectomy is not an uncommon finding in SCA patients. This may be related to inadequate clinical care due to the lack of good health education, ignorance, poverty, and poor standard of care, as well as the lack of newer therapeutic agents.