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Published on: June 11, 2019
Immune dysfunction in the presence of residual splenic tissue
Insights
Residual splenic tissue after splenectomy may impair immune function in children, increasing infection risk. This challenges the belief that remaining spleen tissue offers protection against sepsis.
Area of Science:
- Pediatric immunology
- Surgical outcomes
- Immunological function
Background:
- Splenectomy is performed for trauma and hematologic/oncologic conditions.
- The impact of residual splenic tissue (splenosis) on immune function is not fully understood.
Purpose of the Study:
- To investigate the immunological function in children post-splenectomy.
- To determine the effect of residual splenic tissue on immune response.
Main Methods:
- Assessed immunological function in children who had undergone splenectomy.
- Evaluated for evidence of splenosis (residual splenic tissue).
Main Results:
- Children with residual splenic tissue showed a trend towards immunological dysfunction.
- Significant splenosis was associated with low immunoglobulin levels (IgM, IgG, IgA) and impaired lymphocyte response.
- Trauma patients with minimal splenic tissue had normal immune function.
Conclusions:
- Residual splenic tissue may be linked to impaired immune responses in children.
- Contrary to popular belief, splenosis might increase infection risk due to reduced immune function.
Abstract:
Immunological function was examined in children who had undergone splenectomy, in 8 for trauma, and in 11 for haematologic/oncologic reasons. Particular emphasis was placed on the effects of residual splenic tissue on immune function. Children in the elective group had no evidence of splenosis but 6 of the 8 trauma patients showed residual splenic activity. A general trend indicated that immunological dysfunction was associated with the presence of residual splenic tissue. Three patients with significant post-traumatic splenosis showed low IgM levels, one also had a low IgG level and another a low IgA and impaired lymphocyte response to mitogens. The trauma patients with little or no splenic tissue had normal immune functions. Immunological abnormalities were found in 8 of the 11 haematologic/oncologic patients with no splenosis suggesting the abnormalities were possibly due to the primary disease. In contrast to the popular belief that splenosis confers protection against overwhelming sepsis, the present findings suggest that patients with residual splenic tissue are at a greater risk of infection because of a lower level of immune response.
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