Guralnik V, Schäffler A, Schölmerich J, Schlitt H J, Müller-Wille R, Feuerbach S, Obermeier F
Klinik und Poliklinik für Innere Medizin I, Universitätsklinik Regensburg.
Dtsch Med Wochenschr. 2008 Sep;133(38):1893-6. doi: 10.1055/s-0028-1085572. Epub 2008 Sep 10.
A 52-year-old man with liver cirrhosis and ascites, hepatorenal syndrome and severe pancytopenia was admitted to hospital for treatment and consideration for future liver transplantation.
Laboratory tests revealed severe leukocytopenia and thrombocytopenia, which had persisted after otherwise successful treatment of spontaneous bacterial peritonitis and a hepatorenal syndrome. There was no evidence of a toxic cause such as drugs or alcohol nor of an underlying haematologic disease. The most likely diagnosis was hypersplenism.
DIAGNOSIS, THERAPY AND CLINICAL COURSE: Because of the high risk of a splenectomy it was decided to perform a partial splenic arterial embolization. Both leukocyte and thrombocyte counts rose after the intervention and continued to stay within normal range. This made it possible to discharge the patient from inpatient treatment until he was admitted again for a subsequently successful liver transplantation.
Partial splenic artery embolization can be successfully used to treat severe leukocytopenia and thrombocytopenia in patients with liver cirrhosis and hypersplenism.
一名52岁男性，患有肝硬化、腹水、肝肾综合征及严重全血细胞减少症，因接受治疗及考虑未来肝移植而入院。
实验室检查显示严重白细胞减少和血小板减少，自发性细菌性腹膜炎及肝肾综合征经成功治疗后，这些症状仍持续存在。没有药物或酒精等中毒原因的证据，也没有潜在血液系统疾病的证据。最可能的诊断是脾功能亢进。
诊断、治疗与临床病程：由于脾切除术风险高，决定进行部分脾动脉栓塞术。干预后白细胞和血小板计数均升高，并持续保持在正常范围内。这使得患者可以出院，直到后来再次入院成功进行肝移植。
部分脾动脉栓塞术可成功用于治疗肝硬化和脾功能亢进患者的严重白细胞减少和血小板减少。
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