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    Asplenia/Hyposplenia

    Asplenia/Hyposplenia is a topic covered in the 5-Minute Pediatric Consult.

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    Basics

    Description

    • Asplenia is the absence of the spleen due to either a congenital anomaly or a surgical procedure.
    • Hyposplenia is the reduced or absent function of the spleen, impairing the capacity to prevent bacterial infections.

    Epidemiology

    • The exact incidence is not known.
    • Asplenia is present in about 3% of neonates with structural heart disease.
    • Isolated asplenia is most often recognized at autopsy.

    Pathophysiology

    • The spleen is a major component of the reticuloendothelial system; it is important both for antibody synthesis and for clearance of opsonized organisms by phagocytosis.
    • Antibody-mediated phagocytosis is the primary mechanism to destroy encapsulated microbes, such as pneumococcus, meningococcus, and Haemophilus.
    • In the absence of the spleen’s phagocytic pathway, the polysaccharide-rich capsules of these bacteria protect them from destruction and permit them to effect systemic bacterial infection that may lead to overwhelming sepsis.
    • For patients <4 years of age in whom few alternate routes of bacterial clearance exist, significant pathology can result from impaired splenic function.

    Etiology

    • Surgical splenectomy
    • Congenital asplenia
    • In association with certain diseases or conditions (see “Differential Diagnosis”)

    Commonly Associated Conditions

    • Besides splenectomy, when asplenia is known, patients with certain diseases are at risk of asplenia or hyposplenia (see “Differential Diagnosis”).
    • Asplenia or hyposplenia should be suspected in any patient with overwhelming infection with an encapsulated organism.

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    Citation

    Cabana, Michael D., editor. "Asplenia/Hyposplenia." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617302/all/Asplenia_Hyposplenia.
    Asplenia/Hyposplenia. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617302/all/Asplenia_Hyposplenia. Accessed April 18, 2019.
    Asplenia/Hyposplenia. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617302/all/Asplenia_Hyposplenia
    Asplenia/Hyposplenia [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 18]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617302/all/Asplenia_Hyposplenia.
    * Article titles in AMA citation format should be in sentence-case
    TY - ELEC T1 - Asplenia/Hyposplenia ID - 617302 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617302/all/Asplenia_Hyposplenia PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -