A Triad of Hematologic Diseases in a Military Member Requiring Splenectomy Case Report

Hereditary spherocytosis and sickle cell disease are two distinct hematologic diseases that affect the morphology of the red blood cell, causing implications related to splenic sequestration. Concurrent disease is very rare, with even fewer reported instances requiring surgical intervention. Furthermore, an individual with a third concomitant hematologic abnormality such as Factor VII deficiency, which degrades the normal clotting cascade, has not previously been reported. We describe an active-duty servicemember with known hereditary spherocytosis, sickle cell trait, and Factor VII deficiency who had recurrent worsening pain crises post-flight. The resulting hepatobiliary and splenic damage that ensued ultimately required splenectomy. These diseases in combination further enhance risks associated with splenic damage and intra-operative bleeding, with special consideration for intra-operative risk management and long-term sequala from end-organ damage. The military population exacerbates these conditions where physical exertion, high-altitude travel, and rapid geographic reassignment are considered the norm. This case of a servicemember with a unique disease triad managed successfully with surgical correction underscores the importance of individualized care planning and consideration of duty readiness.