Symeonidis A, Papakonstantinou C, Seimeni U, Sougleri M, Kouraklis-Symeonidis A, Lambropoulou-Karatza C, Vagenakis A, Zoumbos N
Hematology Division, University of Patras Medical School, PO Box 1045, 261.10 Patras, Greece.
Acta Haematol. 2001;105(1):53-6. doi: 10.1159/000046534.
Splenic infarction in patients with sickle cell trait is usually related to hypoxic conditions, while non-hypoxia-related infarcts are extremely rare. We report on a case of a 17-year-old male patient, living at sea level, who developed a severe left upper quadrant abdominal pain during the course of a febrile episode. On physical examination he had a mildly palpable but extremely painful spleen. A spleen scan revealed 2 areas of impaired radionucleide distribution. Hepatic enzymes were moderately increased and the IgM anti-EBV antibodies positive. Hemoglobin electrophoresis revealed the presence of 42% of hemoglobin S. A probable diagnosis of splenic infarction was established in a patient with sickle cell trait, during the course of infectious mononucleosis. The patient was treated symptomatically. The conditions of splenic congestion induced by the EBV infection and the high-grade fever may have contributed to splenic sequestration and subsequent infarcts.
