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Hereditary spherocytosis: Retrospective evaluation of 65 children
Ali Güngör1, Neşe Yaralı1, Ali Fettah1
1Department of Pediatric Hematology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital, Ankara, Turkey.
Insights
Hereditary spherocytosis (HS) is a congenital hemolytic anemia. This study found gallstones were the most common complication in children with HS, necessitating regular ultrasounds.
Area of Science:
- Pediatrics
- Hematology
- Genetics
Background:
- Hereditary spherocytosis (HS) is a common inherited hemolytic anemia in Caucasians.
- It can be diagnosed at any age and presents with anemia, jaundice, and splenomegaly.
Purpose of the Study:
- To analyze demographic, clinical, and laboratory findings of children with HS.
- To identify complications during follow-up in pediatric HS patients.
Main Methods:
- Retrospective study of 65 children diagnosed with HS between January 2008 and September 2013.
- Data collected included age at diagnosis, family history, HS severity classification, and complications.
Main Results:
- The median age at diagnosis was 48 months; 72.3% had a family history.
- 20% experienced aplastic crisis, 30.8% developed cholelithiasis (gallstones).
- Splenectomy was performed in 20% of patients with no post-operative sepsis or thrombosis.
Conclusions:
- HS should be suspected in children with anemia, jaundice, and splenomegaly, with family history being crucial.
- Cholelithiasis is the most frequent complication, requiring intermittent abdominal ultrasonography surveillance even in mild cases.
Abstract:
Güngör A, Yaralı N, Fettah A, Ok-Bozkaya İ, Özbek N, Kara A. Hereditary spherocytosis: Retrospective evaluation of 65 children. Turk J Pediatr 2018; 60: 264-269. Hereditary spherocytosis (HS) is a common cause of congenital hemolytic anemia in Caucasians and it could be diagnosed at any age. The aim of this study is to examine the demographic characteristics, clinical features and laboratory findings of children with HS and their complications observed during follow up. Sixty-five patients, with hereditary spherocytosis between January 2008 and September 2013, were enrolled into this retrospective study. The age of patients at the time of diagnosis varied between 15 days and 17 years. The median age of patients at diagnosis was 48 months (IQR 2-78). The female/male ratio was 1.1. Forty-seven patients (72.3%) had a family history of HS. The patients were classified according to laboratory findings: 13 of them (20%) were diagnosed as mild HS, 36 (55.4%) as moderate HS and of 16 (24.6%) as severe HS. During follow-up, nine patients (13.8%) experienced an aplastic crisis. Megaloblastic crisis was not observed in any patient. Twenty patients (30.8%) had cholelithiasis. Splenectomy was performed in 20% of patients and the mean age for splenectomy was 8.3 years. Complications such as sepsis or thrombosis were not detected after splenectomy. Hereditary spherocytosis should be kept in mind in patients with anemia, jaundice and splenomegaly and the family history must be questioned. The most common complication was gallstone; even patients without severe hemolysis should be followed intermittently by abdominal ultrasonography in order to control the development of gallstone.
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