Wollenberg B, Riera-Knorrenschild J, Neubauer A, Görg C
Klinik für Hämatologie/Onkologie/Immunologie, Philipps-Universität Marburg, Germany.
Ultraschall Med. 2001 Dec;22(6):289-92. doi: 10.1055/s-2001-18919.
Functional hyposplenia/asplenia is a severe longterm complication after allogeneic stemcell transplantation predominantly seen in patients who suffer from extensive chronic graft versus host disease (cGvHD). The risk of acquiring an overwhelming infection with encapsulated bacteria is ca. four fold increased in patients with functional hyposplenia/asplenia. Therefore follow up of patients who have received allogeneic blood stem cells (bone marrow or peripheral blood stem cells) should embrace screening for functional hyposplenia. When functional hyposplenia is diagnosed triple vaccination against streptococcus pneumonia, Haemophilus influenza type B and Meningococcus neisseria should be considered. Goldstandard in diagnosing functional hyposplenia is hepatosplenic scintigraphy. We present the case of 37 year old female in whom sonography was indicative of functional hyposplenia. The diagnosis was confirmed by scintigraphy. Sonography including color coded duplex sonography is a safe and cost saving procedure. Sensitivity, Specificity and predictive value of the following sonographic finding: a) decreasing splenic size and b) diminished or absent parenchymal blood flow are currently evaluated in a prospective study.
功能性脾功能减退/无脾是异基因干细胞移植后的一种严重长期并发症，主要见于患有广泛慢性移植物抗宿主病（cGvHD）的患者。功能性脾功能减退/无脾患者发生包膜细菌所致暴发性感染的风险约增加四倍。因此，对接受异基因血液干细胞（骨髓或外周血干细胞）移植的患者进行随访时应包括功能性脾功能减退的筛查。诊断为功能性脾功能减退时，应考虑接种针对肺炎链球菌、B型流感嗜血杆菌和脑膜炎奈瑟菌的三联疫苗。诊断功能性脾功能减退的金标准是肝脾闪烁扫描。我们报告一例37岁女性病例，超声检查提示功能性脾功能减退。闪烁扫描证实了诊断。包括彩色编码双功超声在内的超声检查是一种安全且节省成本的检查方法。一项前瞻性研究目前正在评估以下超声检查结果的敏感性、特异性和预测价值：a）脾脏大小减小；b）实质血流减少或消失。
