Functional asplenia in systemic lupus erythematosus

Area of Science:

• Immunology
• Rheumatology
• Infectious Diseases

Background:

• Systemic lupus erythematosus (SLE) is a chronic autoimmune disease.
• Functional asplenia, a condition where the spleen does not function properly, can occur in SLE patients.
• Functional asplenia increases susceptibility to severe infections, particularly from encapsulated bacteria.

Observation:

• A case of inactive SLE with pneumococcal sepsis, disseminated intravascular coagulation, shock, renal failure, and functional asplenia is presented.
• Functional asplenia was diagnosed via a 99mtechnetium-labeled sulfur colloid spleen scan showing no uptake.
• A literature review identified ten similar cases of functional asplenia in SLE patients, with six experiencing severe sepsis.

Findings:

• The patient with SLE and functional asplenia was successfully treated for pneumococcal sepsis.
• The patient demonstrated a robust antibody response to pneumococcal vaccination.
• Spleen scan abnormalities resolved completely within one year.

Implications:

• Functional asplenia is a rare but significant complication in SLE.
• It predisposes patients to severe bacterial infections, particularly pneumococcal sepsis.
• Early diagnosis and management of functional asplenia in SLE are critical for preventing life-threatening septic events.