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Splenectomy in Nigerian children with sickle cell anaemia
B A Okoro1, W N Kaine, T C Okeahialam
1Department of Paediatrics, University of Nigeria Teaching Hospital, Enugu.
Insights
Splenectomy improved health in Nigerian children with sickle cell anaemia and hypersplenism. However, it did not eliminate pain crises, limiting its use for most patients.
Area of Science:
- Pediatrics
- Hematology
- Surgical Oncology
Background:
- Sickle cell anaemia is a prevalent genetic blood disorder in Nigeria.
- Hypersplenism can complicate sickle cell anaemia, leading to intractable symptoms.
- Splenectomy is a potential treatment for hypersplenism.
Observation:
- This study reviewed 4359 children with sickle cell anaemia treated between 1979-1986.
- Four children with hypersplenism underwent splenectomy for intractable complaints.
- Outcomes were monitored for improvements in haematological indices and general wellbeing.
Findings:
- Splenectomy led to improved haematological parameters and overall wellbeing in the treated children.
- However, splenectomy did not eradicate abdominal or bone pain crises associated with sickle cell anaemia.
- The benefits of splenectomy were observed in carefully selected cases of hypersplenism.
Implications:
- Splenectomy can be a beneficial therapeutic option for select pediatric patients with sickle cell anaemia and hypersplenism.
- It is not a primary treatment modality for the majority of children suffering from sickle cell anaemia in Nigeria.
- Further research may explore alternative or adjunctive therapies to manage pain crises effectively in these patients.
Abstract:
A total of 4359 children with sickle cell anaemia were treated at the University of Nigeria Teaching Hospital, Enugu, Nigeria in an eight year period 1979-1986. Of this number 4 children with hypersplenism associated with intractable complaints were offered splenectomy as the treatment of choice. Following splenectomy they had improved haematological indices and general wellbeing, but splenectomy did not abolish abdominal or bone pain crises. This study emphasizes that though splenectomy could be of beneficial effect on carefully chosen cases of hypersplenism, it has not become a major form of therapy for the majority of children with sickle cell anaemia in Nigeria.