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Growth Failure in Hereditary Spherocytosis and the Effect of Splenectomy
Anirban Das1, Deepak Bansal, Amita Trehan
1Pediatric Hematology/Oncology unit, Department of Pediatrics and *Department of Hematology, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Correspondence to: Dr Deepak Bansal, Professor, Hematology-Oncology unit, Department of Pediatrics, Advanced Pediatrics Center, PGIMER, Chandigarh, India. deepakbansaldr@gmail.com.
Insights
Growth failure is common in children with hereditary spherocytosis in India. While splenectomy (surgical removal of the spleen) corrects anemia, it does not improve growth outcomes.
Area of Science:
- Pediatric Hematology
- Growth and Development
- Surgical Outcomes
Background:
- Hereditary spherocytosis is a genetic blood disorder causing red blood cell destruction.
- Growth failure, including stunting and underweight, is a significant concern in affected children.
- The role of splenectomy in addressing growth issues in these children remains unclear.
Purpose of the Study:
- To evaluate growth patterns in children with hereditary spherocytosis.
- To assess the impact of splenectomy on growth failure in this population.
- To analyze changes in stunting and underweight status post-splenectomy.
Main Methods:
- Retrospective analysis of 82 case records spanning 27 years (1985-2011).
- Data collection focused on anthropometric measurements and clinical outcomes.
- Comparison of growth parameters before and after splenectomy in a subset of patients (n=26).
Main Results:
- Prevalence of stunting was 26% and underweight was 32% among the study cohort.
- Stunted children were older and presented later for care.
- Splenectomy significantly improved anemia (P<0.001) but did not lead to significant improvements in height-for-age or underweight status at 1 or 4.5 years post-surgery.
Conclusions:
- Growth failure is a frequent complication of hereditary spherocytosis in Indian children.
- Splenectomy effectively treats anemia associated with hereditary spherocytosis.
- However, splenectomy does not appear to improve or resolve pre-existing growth failure in these children.
Objective:
To analyze growth-failure and improvement, if any, following splenectomy in children with hereditary spherocytosis.
Methods:
Data collection from case-records (n=82) over 27-years (1985-2011).
Results:
Prevalence of stunting was 26%; 32% were underweight. Stunted children were older in age (P=0.006) and presented late (P=0.003). Splenectomy (n=26) improved anemia (P<0.001). However, height-for-age did not improve at 1-year, or 4.5-years (median) following splenectomy (P=1.0). Number of underweight children did not reduce at 1- (P=0.21), or 4.5-years (P=0.21) following surgery.
Conclusion:
Growth-failure is frequent in children with hereditary spherocytosis in India. Splenectomy corrected the anemia but failed to improve the growth.