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Topic: Asplenia

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	eMedicine - Asplenia : Article by Joseph C Turbyville, MD (Site not responding. Last check: 2007-11-05)
		Asplenia may be associated with caudal deficiency or cystic disease of the liver, kidney, and pancreas.
		Asplenia is associated with dextrocardia in approximately one third of the cases.
		Asplenia or polysplenia is present in approximately 3% of neonates with structural heart disease and in 30% of patients who die from cardiac malposition.
	www.emedicine.com /ped/topic150.htm (6024 words)

	TheFetus.net - Polysplenia syndrome -Rudolph P. Fedrizzi, MD, Joseph P. Bruner, MD, Philippe Jeanty, MD, PhD
		By contrast, asplenia syndrome is a syndrome of right-isomerism.
		Acyanosis at birth is typical of polysplenia, whereas cyanosis is the rule in asplenia due to pulmonary outflow obstruction from stenosis or atresia.
		The asplenia syndrome: an explanation for absence of the spleen.
	www.thefetus.net /page.php?id=61 (2467 words)

	Asplenia - Wikipedia, the free encyclopedia
		Asplenia refers to the absence ('a-') of normal spleen function and is associated with some risks.
		Asplenia may be congenital (congenital asplenia), or acquired through surgery (splenectomy) or through processes that destroy the spleen, generally through its function to filter the blood and therefore referred to as autosplenectomy (eg spherocytosis and sickle-cell disease).
		Asplenia increases the risk of septicaemia from encapsulated bacteria, and can result in a syndrome known as overwhelming post splenectomy infection (OPSI) which can kill within a few hours.
	en.wikipedia.org /wiki/Asplenia (769 words)

	eMedicine - Asplenia : Article Excerpt by: Joseph C Turbyville, MD (Site not responding. Last check: 2007-11-05)
		Asplenia and splenic hypoplasia are terms used to indicate complete or partial lack of splenic function.
		Isolated asplenia or hyposplenia is often diagnosed only after the patient has had a serious, fulminant, and often fatal infection.
		Because the spleen is important in antibody synthesis and has a critical role in clearing bacteria from the bloodstream, a patient with asplenia is at significant risk for life-threatening infections and fulminant sepsis, especially in their first 2 years of life.
	www.emedicine.com /ped/byname/asplenia.htm (689 words)

	Prevention and therapy of bacterial infections for children with asplenia or hyposplenia
		Therefore, children with asplenia and their families must be educated to notify their physicians promptly about any signs or symptoms of an infection, even ‘minor’ symptoms such as those associated with upper respiratory tract infections.
		The antibody response in children with asplenia to polysaccharide vaccines, such as pneumococcal and meningococcal vaccines, may not be comparable with that of normal children.
		The CPS recommends that, despite the use of prophylactic antibiotics and/or vaccines, children with asplenia or hyposplenia be considered at high risk of serious bacterial infection and, thus, be closely monitored for febrile illness, promptly assessed for infectious causes when fever occurs, and receive aggressive antimicrobial therapy whenever an infection is suspected.
	www.cps.ca /english/statements/ID/id99-04.htm (2485 words)

	Use of Vaccines in Persons With Altered Immunocompetence : Bureau of Immunization : NYC DOHMH
		asplenia) such patients may be at higher risk for certain diseases, and additional vaccines, particularly bacterial polysaccharide vaccines (Haemophilus influenza type b [Hib], pneumococcal and meningococcal) are recommended for them.
		Persons with conditions that cause limited immune deficits (e.g., asplenia, renal failure) that may require use of special vaccines or higher doses of vaccines but that do not contraindicate use of any particular vaccine.
		Asplenia: Persons who have anatomic or functional asplenia have an increased risk for fulminate bacteria, associated with a high mortality rate.
	www.nyc.gov /html/doh/html/imm/immcomp.shtml (1089 words)

	eMedicine - Asplenia/Polysplenia : Article by Marta Hernanz-Schulman, MD, FAAP (Site not responding. Last check: 2007-11-05)
		In patients with asplenia, a single atrium that morphologically resembles a right atrium tends to be present, whereas in patients with polysplenia, the atrium morphologically resembles a left atrium.
		Anomalies of the pancreas may be somewhat more difficult to assess in the absence of the spleen because of the lack of splenic vascular landmarks, particularly in young patients in whom pancreatic attenuation may be similar to that of the surrounding tissue and in whom abdominal fat is scarce or absent.
		Sagittal ultrasonogram in an infant with asplenia demonstrates the characteristic staircase configuration of the ventral course of the superior mesenteric–portal junction anterior to pancreas and duodenum.
	www.emedicine.com /radio/topic58.htm (7576 words)

	New Page 1
		Asplenia syndrome is characterized by complex congenital heart defects, asplenia and abdominal heterotaxy.
		It is concluded that asplenia syndrome is a focal developmental disturbance in laterality which occurs primarily at Horizon XIII.
		Radionuclide imaging with the new generation of hepatobiliary agents is a reliable method to document asplenia and is useful in studying patients with visceral heterotaxy.
	www.pediheart.org /searches/topic/heterotaxy.htm (6083 words)

	AEGiS-MMWR: Prevention of Pneumococcal Disease: Recommendations of the Advisory Committee on Immunization Practices ...
		Persons with functional or anatomic asplenia (e.g., sickle cell disease or splenectomy) are at highest risk for pneumococcal infection, because this condition leads to reduced clearance of encapsulated bacteria from the bloodstream.
		Persons aged greater than or equal to 2 years with anatomic or functional asplenia (e.g., from splenectomy or sickle cell disease) generally respond to pneumococcal vaccination with antibody levels comparable with those observed in healthy persons of the same age (47).
		These children include those with functional or anatomic asplenia (e.g., sickle cell disease or splenectomy) and those with conditions associated with rapid antibody decline after initial vaccination (e.g., nephrotic syndrome, renal failure, or renal transplantation).
	www.aegis.com /pubs/MMWR/1997/RR4608-1.html (9105 words)

	Chapter 35- Oliver W. Caminos, M.D. (Site not responding. Last check: 2007-11-05)
		Asplenia occurs many times with complex congenital heart disease.
		Probably the most prevalent malformation in a single ventricle or large V.S.D. with pulmonary stenosis which may produce a clinical and hemodynamic picture similar to tetralogy of fallot.
		Left superior vena cava and connection of left superior vena cava to the left atrium can also be seen with asplenia.
	www.redtail.net /owc/35.html (91 words)

	Publication Details - John Lamberti - Stanford University School of Medicine (Site not responding. Last check: 2007-11-05)
		Two neonates with asplenia syndrome, subdiaphragmatic total anomalous pulmonary venous connection, and pulmonary stenosis underwent a palliative operation without cardiopulmonary bypass.
		(Since children with asplenia syndrome have common mixing lesions, pulmonary venous drainage to the right atrium is not physiologically detrimental.) The descending vertical vein was ligated.
		We conclude that, in infants with asplenia syndrome and obstructed total anomalous pulmonary venous drainage, relief of pulmonary venous obstruction can be accomplished without cardiopulmonary bypass.
	med.stanford.edu /profiles/cvi/frdActionServlet?choiceId=showPublication&pubid=51343&fid=5985 (184 words)

	TheFetus.net - Asplenia-polysplenia syndromes -Sandra R Silva, MD & Philippe Jeanty, MD, PhD
		It results (with simplifications) in either a fetus with a predominant right-sided ness and an isomeric left side (asplenia: a fetus whose left side is a mirror image of its right side) or left-sidedness and an isomeric right side (polysplenia: a fetus whose right side is a mirror image of its left side).
		Prognosis: Asplenia tends to be a more severe disease because of the cyanotic heart lesions and the superimposed infections.
		Although morbidity and mortality in the neonatal period are determined mainly by the cardinal cardiac defects, the visceral anomalies may strongly affect the long-term outcome of these patients.
	www.thefetus.net /page.php?id=407 (879 words)

	RedOrbit - Health - Pneumococcal Sepsis: Should We Look for Asplenia?
		Clinicians are well versed in the need lor protection against S. pneumonias where the spleen is known to be absent, either through functional asplcnia as in sickle-cell anaemia or acquired asplenia after trauma or surgery.
		Congenital asplcnia may occur as an isolated condition, in recognized malformation syndromes or in family clusters.2 Where a syndrome or family history alerts the clinician to possible asplcnia, confirmatory investigations should lead to effective prophylaxis.
		Asplenia is diagnosed through two easy and non-invasive investigations-a search for Howell- Jolly bodies on blood smears, which are characteristic of but not specific for asplcnia, or abdominal ultrasound.
	www.redorbit.com /news/display?id=113273 (788 words)

	Ivemark syndrome in association with congenital septum transversum defect and pancreatic divisum Sharma Shilpa, ... (Site not responding. Last check: 2007-11-05)
		The characteristic association of asplenia with visceroatrial heterotaxia is traditionally named after the Swedish pediatrician, Ivemark.
		She was given pneumococcus vaccine for asplenia along with regular immunization as per schedule.
		Patients should be placed on chemoprophylaxis for asplenia as soon as the diagnosis is made.
	www.indianjgastro.com /article.asp?issn=0254-8860;year=2006;volume=25;issue=2;spage=94;epage=96;aulast=Sharma (926 words)

	THE MERCK MANUAL OF GERIATRICS, Ch. 132, Immunization
		Blacks and American Indians of any age are more susceptible to invasive pneumococcal infection; they are also more likely to have conditions that increase risk of this infection.
		Such conditions include sickle cell disease, nephrotic syndrome, splenic dysfunction, anatomic asplenia (eg, surgical splenectomy), chronic renal failure, SLE, diabetes mellitus, chronic cardiopulmonary disorders, and certain immunosuppressive disorders (eg, leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, multiple myeloma).
		The Advisory Committee on Immunization Practices recommends one-time revaccination after 5 yr for people with nephrotic syndrome, chronic renal failure, splenic dysfunction, anatomic asplenia, or an immunosuppressive disorder.
	www.merck.com /mrkshared/mmg/sec16/ch132/ch132d.jsp (318 words)

	Asplenia and Polysplenia: Implications for Abdominal Sonography -- Patel et al. 7 (3): 132 -- Journal of Diagnostic ...
		Asplenia and Polysplenia: Implications for Abdominal Sonography -- Patel et al.
		Abdominal sonograms on seven patients with asplenia syndrome
		All seven patients with asplenia had a horizontal
	jdm.sagepub.com /cgi/content/abstract/7/3/132 (248 words)

	The Group on Immunization Education of the Society of Teachers of Family Medicine
		Asplenia including elective splenectomy and terminal complement component deficiencies.
		Influenza vaccine: There are no data specifically on risk of severe or complicated influenza infections among persons with asplenia.
		However, influenza is a risk factor for secondary bacterial infections that may cause severe disease in asplenics.
	www.immunizationed.org /ShotsMed.asp?DesId=43&ThisName=HIV+Infection (293 words)

	Asplenia Guidelines Part 4 (Site not responding. Last check: 2007-11-05)
		The Immunisation Guidelines for Ireland (2002 Edition) recommends Hib vaccine for “persons with functional or anatomical asplenia, irrespective of age”.
		The conjugated Hib vaccine was introduced into the childhood immunisation programme in Ireland in October 1992.
		The Immunisation Guidelines for Ireland (2002 Edition) strongly recommend influenza vaccination for adults and children with “immunosuppression due to disease or treatment, including asplenia or splenic dysfunction”.
	www.shb.ie /content-1007791418_1.cfm (193 words)

	Government and academic resources on Asplenia
		Pearson HA, Spencer RP and Cornelius E A. Functional asplenia in...
		...asplenia, terminal complement component deficiencies, and HIV infection.
		...sickle cell disease, asplenia, or chronic systemic illnesses is recommended.
	books.mongabay.com /health/conditions/Asplenia.html (408 words)

	B-1a B Cells that Link the Innate and Adaptive Immune Responses Are Lacking in the Absence of the Spleen -- Wardemann ... (Site not responding. Last check: 2007-11-05)
		Asplenia syndrome: insight into embryology through an analysis of cardiac and extracardiac anomalies.
		Congenital asplenia detected in a 60 year old patient with septicemia.
		Asplenia as cause of sudden unexpected death in childhood.
	www.jem.org /cgi/content/full/195/6/771 (5504 words)

	Congenital asplenia - Wikipedia, the free encyclopedia
		Congenital Asplenia is a condition in which a newborn baby is missing its spleen.
		This condition is due to genetic disorders (or exposure to environmental factors during gestation) and increases the risk of infection and can, ultimately, lead to the death of the baby.
		Asplenia with cardiovascular anomalies - Geneva Foundation for Medical Education and Research
	en.wikipedia.org /wiki/Congenital_asplenia (88 words)

	Ivemark Syndrome
		Cesko I, et al., Ivemark syndrome with asplenia in siblings.
		Wolfe M, et al., Prolonged and functional survival with the asplenia syndrome.
		Monie I, The asplenia syndrome: an explanation for absence of the spleen.
	hw.healthdialog.com /kbase/nord/nord740.htm (855 words)

	Splenectomy, Hyposplenism and Asplenia - Patient UK
		Splenectomy, Hyposplenism and Asplenia - Patient UK PatientPlus articles are written for doctors and so the language can be technical.
		However, some people find that they add depth to the articles found in the other sections of this website which are written for non-medical people.
		Congenital asplenia (associated with cardiac abnormalities and biliary atresia)
	www.patient.co.uk /showdoc/40024811 (815 words)

	Hope for Patients with Asplenia or Hyposplenism - caring for patients with spleen abnormalities American Family ... (Site not responding. Last check: 2007-11-05)
		Hope for Patients with Asplenia or Hyposplenism - caring for patients with spleen abnormalities
		A careful examination for abdominal scars may be valuable when a patient is unable to provide a good medical history.
		Although this is seldom reported, Howell-Jolly bodies are a useful laboratory clue to the diagnosis of hyposplenism or asplenia.
	www.findarticles.com /p/articles/mi_m3225/is_3_63/ai_72766903 (730 words)

	UpToDate Immunizations in adults with corticosteroid therapy, asplenia, and congenital immunodeficiency
		Immunizations in adults with corticosteroid therapy, asplenia, and congenital immunodeficiency
		— Patients with functional (eg, due to sickle cell disease) or anatomic asplenia (congenital or postsplenectomy) have defective clearance of encapsulated bacteria from the circulation, placing them at a lifetime risk as high as five percent of developing fulminant sepsis with these organisms [1-3].
		(See "Approach to the adult patient with splenomegaly", section on Hyposplenism and asplenia and see "Clinical features, management, and prevention of sepsis in the splenectomized patient").
	patients.uptodate.com /print.asp?print=true&file=immunize/9320 (526 words)

	Arch Intern Med -- Abstract: Acquired functional asplenia. Association with spontaneous rupture of the spleen and fatal ...
		Association with spontaneous rupture of the spleen and fatal spontaneous rupture of the liver in amyloidosis, June 1, 1980, Hurd and Katholi 140 (6): 844
		neither acquired functional asplenia nor spontaneous rupture of the liver
		Spontaneous rupture of the spleen: ultrasound patterns, diagnosis and follow-up
	archinte.ama-assn.org /cgi/content/abstract/140/6/844 (157 words)

	Human Immunoglobulin M Memory B Cells Controlling Streptococcus pneumoniae Infections Are Generated in the Spleen -- ...
		asplenia is very low and most children born without spleen die
		On the bottom, IgM and switched memory B cells were identified as described in Fig.
		1 A. Congenital asplenia is a rare malformation associated to life-threatening
	www.jem.org /cgi/content/full/197/7/939 (3953 words)

	The Ultimate Spleen Dog Breeds Information Guide and Reference
		Congenital abnormalities such as accessory spleens occur, and rarely the spleen has been found to be completely absent.
		Sickle-cell disease can cause a functional asplenia by causing infarctions in the spleen during repeated sickle-cell crises.
		In certain animals such as dogs and horses, the spleen sequesters a large number of erythrocytes (red blood cells), which can be dumped into the bloodstream during periods of physical exertion.
	www.dogluvers.com /dog_breeds/Spleen (682 words)

	Immunization of adults - pneumovax
		Individuals over age 2 with alcoholism, cirrhosis, cerebrospinal fluid leaks, congestive heart failure, coronary artery disease, diabetes, emphysema, lupus, renal failure, nephrotic syndrome, lymphoma, multiple myeloma, functional or anatomic asplenia, organ transplant, and AIDS.
		Revaccination at 6 years for those people with asplenia, renal failure, nephrotic syndrome, and transplant.
		21% efficacy in 175 immunocompromised (asplenia, transplants, nephrotic, lupus, hematologic malignancy).
	www.acsu.buffalo.edu /~shlevy/immune.htm (1584 words)

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