Pre-splenectomy permanent tooth extraction in a child with hereditary spherocytosis: a case report and guidelines

Patrick Pereira Garcia1, Luenny Maria Moraes Pinheiro1, Wellington José Alves Nunes2

  • 1Postgraduate Program in Dentistry, Ceuma University, 65075-120 São Luís, MA, Brazil.

Hereditary Spherocytosis (HS) is a type of hemolytic anemia characterized by a defect in the membrane of red blood cells, which causes them to assume a spherical shape, become osmotically fragile, and be prone to early hemolysis. While it is relatively well understood in the medical field, there is limited evidence regarding the dental management of patients with this condition. Therefore, this report aims to present a case involving the extraction of permanent teeth before splenectomy in a child with HS who had been hospitalized. Additionally, treatment guidelines for these patients are proposed and developed. The patient was scheduled to undergo a total splenectomy due to splenomegaly resulting from severe hemolytic anemia. Prior to the surgery, the child was referred to the hospital's dental clinic with a chief complaint of dental pain. An intraoral examination revealed carious lesions with pulpal involvement in the first molars, and extraction was recommended to minimize the risk of post-splenectomy infection. Hematological support was provided during dental treatment since partial control of the anemia was necessary for the extraction procedure. Developing dental treatment guidelines for patients with HS is essential to ensure their safety.