Related Experiment Videos
Reversible functional asplenia in systemic lupus erythematosus
1Department of Medicine, North Shore University Hospital/Cornell University Medical College, Manhasset, New York 11030.
Clinical Nuclear Medicine
|October 1, 1991
Summary
Systemic lupus erythematosus can cause temporary spleen dysfunction. Immune complexes transiently blocked the reticuloendothelial system, impacting spleen imaging in a septic shock patient.
Area of Science:
- Immunology
- Nuclear Medicine
- Critical Care Medicine
Background:
- Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
- Septic shock can lead to multi-organ dysfunction, including renal failure and disseminated intravascular coagulation (DIC).
- Reticuloendothelial system (RES) function is crucial for immune surveillance and clearance.
Observation:
- A 44-year-old woman with SLE presented with septic shock, renal failure, and DIC.
- Initial liver-spleen scintigraphy using Tc-99m albumin colloid showed no spleen uptake.
- Follow-up imaging one year later demonstrated normal spleen tracer uptake.
Findings:
- The transient absence of spleen uptake on scintigraphy suggests a temporary RES blockade.
- Immune complexes associated with SLE are the most probable cause of this blockade.
- Disseminated intravascular coagulation-induced thrombosis or vasculitis are alternative explanations for impaired spleen visualization.
Implications:
- This case highlights a rare, reversible complication of SLE and critical illness.
- It underscores the importance of considering RES function in patients with autoimmune diseases and severe infections.
- Transient RES blockade may affect diagnostic imaging interpretation in critically ill patients.