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Pediatric Asplenia Follow-up

  • Author: Mudra Kumar, MD, MRCP, FAAP; Chief Editor: Harumi Jyonouchi, MD  more...
 
Updated: Nov 11, 2014
 

Further Inpatient Care

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  • The most difficult and crucial aspect of asplenia is establishing the diagnosis.
    • Although this task is relatively simple in patients with accompanying anomalies, especially complex cyanotic cardiac problems, and in those with a family history of the condition, the patient with isolated asplenia or hyposplenia may not be easily identified.
    • The diagnosis is often made at autopsy.
  • Patients require regular monitoring with an established provider.
  • All immunizations, including routine childhood vaccinations and additional immunizations, are recommended (see Medical Care).
    • These vaccinations should be administered at the earliest opportunity.
    • Close observation and monitoring is mandatory, especially in the first few years of childhood, to educate the family and to ensure compliance with antibiotic prophylaxis.
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Prognosis

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  • With early diagnosis and aggressive treatment, the long-term prognosis of a child with isolated congenital asplenia is good.
    • The risk of overwhelming sepsis, although it does not end, significantly decreases in individuals older than 5 years.
    • The primary care physician plays an integral role in the identification and long-term treatment of patients with asplenia.
  • Congenital asplenia, polysplenia, and hypoplasia may be underdiagnosed. An increased awareness of their existence may be crucial and life-saving in immunocompromised individuals with these conditions.
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Patient Education

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  • See Medical Care.
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Contributor Information and Disclosures
Author

Mudra Kumar, MD, MRCP, FAAP Professor of Pediatrics, Course Director, Course 6 MSII, Preclerkship Director, Clinical Integration, Department of Pediatrics, University of South Florida Morsani College of Medicine

Mudra Kumar, MD, MRCP, FAAP is a member of the following medical societies: American Academy of Pediatrics, American Society of Hematology, American Society of Pediatric Hematology/Oncology

Disclosure: Nothing to disclose.

Coauthor(s)

Cecilia P Mikita, MD, MPH Associate Program Director, Allergy-Immunology Fellowship, Associate Professor of Pediatrics and Medicine, Uniformed Services University of the Health Sciences; Staff Allergist/Immunologist, Walter Reed National Military Medical Center

Cecilia P Mikita, MD, MPH is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Allergy, Asthma and Immunology

Disclosure: Nothing to disclose.

Joseph C Turbyville, MD Allergist-Immunologist, Family Allergy and Asthma

Joseph C Turbyville, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American College of Allergy, Asthma and Immunology

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Harumi Jyonouchi, MD Faculty, Division of Allergy/Immunology and Infectious Diseases, Department of Pediatrics, Saint Peter's University Hospital

Harumi Jyonouchi, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American Association of Immunologists, American Medical Association, Clinical Immunology Society, New York Academy of Sciences, Society for Experimental Biology and Medicine, Society for Pediatric Research, Society for Mucosal Immunology

Disclosure: Nothing to disclose.

Acknowledgements

John Wilson Georgitis, MD Consulting Staff, Lafayette Allergy Services

John Wilson Georgitis, MD is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American Academy of Pediatrics, American Association for the Advancement of Science, American College of Chest Physicians, American Lung Association, American Medical Writers Association, and American Thoracic Society

Disclosure: Nothing to disclose.

Francine Gross, MD Consulting Staff, Department of Pediatrics, Winter Haven Hospital

Disclosure: Nothing to disclose.

Acknowledgments

The authors wish to thank Oswaldo Castro, MD, for his assistance in reviewing this manuscript and providing expertise with regards to management of patients with sickle cell disease and asplenia.

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Peripheral blood smear shows Howell-Jolly (HJ) bodies in RBCs.
 
 
 
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