Pediatric Asplenia Follow-up

Updated: Oct 19, 2016
  • Author: Mudra Kumar, MD, MRCP, FAAP; Chief Editor: Harumi Jyonouchi, MD  more...
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Follow-up

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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