Dillon A M, Stein H B, English R A
Ann Intern Med. 1982 Jan;96(1):40-3. doi: 10.7326/0003-4819-96-1-40.
Five of 70 patients with systemic lupus erythematosus seen over a 5-year period had peripheral blood films suggestive of hyposplenism. Technetium-99m-sulfur colloid scans showed no splenic activity in three patients. One of these three patients, who had a spontaneous remission of persistent thrombocytopenia concurrent with the appearance of functional asplenia, had splenic atrophy shown by computed tomography; a second patient, who died of pneumococcal septicemia, was shown to have splenic atrophy with lymphocyte depletion at autopsy. The development of functional asplenia in the third patient has now, to date, had any obvious effect on her disease. In the two patients with normal scans, blood film findings returned to normal with treatment of the underlying disease. Polyvalent pneumococcal vaccine is recommended for patients with lupus erythematosus who have splenic atrophy.
在5年期间诊治的70例系统性红斑狼疮患者中，有5例的外周血涂片提示脾功能减退。99m锝-硫胶体扫描显示3例患者无脾脏活性。这3例患者中的1例，持续性血小板减少症自发缓解，同时出现功能性无脾，计算机断层扫描显示脾脏萎缩；第2例患者死于肺炎球菌败血症，尸检显示脾脏萎缩伴淋巴细胞耗竭。到目前为止，第3例患者功能性无脾的发生对其疾病尚无明显影响。在扫描正常的2例患者中，随着基础疾病的治疗，血涂片检查结果恢复正常。对于有脾脏萎缩的红斑狼疮患者，建议接种多价肺炎球菌疫苗。
