An extreme consequence of splenectomy in dehydrated hereditary stomatocytosis: gradual thrombo-embolic pulmonary hypertension and lung-heart transplantation.

Abstract

Dehydrated hereditary stomatocytosis (DHS) belongs to the heterogeneous class of hemolytic anemias with leaky red cell membranes. Splenectomy is a highly deleterious treatment, because it favors, with virtually no exception, the occurrence of thromboembolic disease. We describe here the extreme case of a patient with DHS and an associated sickle cell trait. Splenectomy was carried out due to a splenic infarction that occurred during an airplane journey. About 12 years later, the patient noticed an exertional dyspnea, which gradually worsened to such a degree that she became severely incapacitated within 5 years. Eventually, the patient developed a cor pulmonale associated with chronic thromboembolic pulmonary hypertension (CTEPH) and successfully underwent a heart-lung transplant operation. This case ranks as one of the most severe examples ever recorded of the effect that splenectomy may have in DHS patients. Nonetheless, it represents the first case to receive a heart-lung transplant.

• Authors: Xavier Jaïs, Stephen J Till, Thérèse Cynober, Vincent Ioos, Gilles Garcia, Gil Tchernia, Philippe Dartevelle, Gérald Simonneau, Jean Delaunay, Marc Humbert
• Journal: Hemoglobin (Hemoglobin) Vol. 27 Issue 3 Pg. 139-47 (Aug 2003) ISSN: 0363-0269 [Print] England
• PMID: 12908798 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Anemia, Hemolytic, Congenital (complications, surgery)
• Anemia, Sickle Cell (complications)
• Dyspnea
• Female
• Heart-Lung Transplantation
• Humans
• Hypertension, Pulmonary (etiology, pathology, surgery)
• Pulmonary Embolism (etiology, pathology, surgery)
• Splenectomy (adverse effects)
• Treatment Outcome