Splenic red cell pool

A similar procedure to that for visualizing the spleen, but with undamaged, labelled red cells, provides a relatively simple method for measuring the splenic red cell volume. By quantitative imaging, the fraction of the administered radionuclide present in the spleen is measured 20-30 min after injection. Normally, the spleen contains 5% or less of the red cell volume (about 60 mL), and there is general correlation between splenic red cell volume and the physical size of the spleen. There is a proportionately greater pool in certain disorders; in these, the pool may be a major cause of splenomegaly. Discrepancies between the volume of the spleen and of the red cell pool suggest that the splenomegaly is due, at least in part, to cell or tumour infiltration. The extent of the splenic red cell pool should be taken into account when assessing the significance of anaemia; it also makes it possible to predict the degree to which anaemia will improve following splenectomy.

Plasma volume

Splenomegaly is often associated with an increased plasma volume and splenectomy is usually followed by a reduction in plasma volume. This means that in splenomegaly the blood count may give an exaggerated impression of anaemia, so that measurement of red cell and plasma volumes must be included in clarifying the cause of anaemia in conditions associated with splenomegaly.

Armas RR (1985) Clinical studies with spleen-specific radiolabeled agents. Semin NuclMed 15: 260-75.

Bowdler AJ ed. (2002) The Complete Spleen: Structure, Function and Clinical Disorders, 2nd edn. Humana Press, Totowa, NJ.

British Committee for Standards in Haematology (1996) Guidelines for the prevention and treatment of infection in patient's with an absent or dysfunctional spleen. Br Med J 312: 430-4.

Buchanan GR, Holtkamp CA (1987) Pocked erythrocyte counts in patients with hereditary spherocytosis before and after splenec-tomy. Am JHematol 25: 253-7.

Caulier MT, Darloy F, Rose C et al. (1995) Splenic irradiation for chronic autoimmune thrombocytopenia purpura in patients with contraindications to splenectomy. Br J Haematol 91: 208-11.

Corazzo R, Bullen AW, Hall R et al. (1981) Simple method of assessing splenic function in coeliac disease. Clin Sci 60: 109-113.

Crane CG (1981) Tropical splenomegaly. Part 2: Oceania. Clin Haematol 10: 976-82.

Davies JM, Barnes R, Mulligan D (2002) Update of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. British Committee for Standards in Haematology Working Party of the Haematology/Oncology Task Force. Clin Med 2: 440-3.

Dokal IS, Deenmamode M, Lewis SM (1990) Detection and functional assessement of accessory splenic tissue (splenunculi) with radiolabelled heat damaged autologous erythrocytes. Clin Lab Haematol 12: 287-93.

Fakunle YM (1981) Tropical splenomegaly. Part 1: Tropical Africa. Clin Haematol 10: 963-75.

Ferrant A, Cauwe F, Michaux JL et al. (1982) Assessment of the sites of red cell destruction using quantitative measurements of splenic and hepatic red cell destruction. Br J Haematol 50: 591-8.

Fishman D, Isenberg DA (1997) Splenic involvement in rheumatoid diseases. Semin Arthritis Rheum 27: 141-155.

Giebink GS (2001) The prevention of pneumococcal disease in children. Review. New EngJ Med 345: 1177-83.

Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Working Party for the British Committee for Standards in Haematology. Clinical Haematology Task Force 1996. Br Med J 312: 430-4.

Harrington WJ (Jr), Harrington TJ, Harrington WJ (Snr). (1990) Is splenectomy an outmoded procedure? Adv Intern Med 35: 415-40.

Jonasson O, Spigos DC, Moyes MF (1985) Partial splenic embol-isation: experience in 136 patients. World J Surg 9: 461-7.

Liu DL, Xia S, Tang J et al. (1995) Allotransplantation of whole spleen in patients with hepatic malignant tumours or hemophilia A. Arch Surgery 130: 33-9.

Messinezy M, Macdonald LM, Nunan TO et al. (1997) Spleen sizing by ultrasound in polycythaemia and thrombocythaemia: comparison with SPECT. Br J Haematol 98: 103-7.

Musser G, Lazar G, Hocking W et al. (1984) Splenectomy for haematologic disease: the UCLA experience with 306 patients. Ann Surg200: 40-5.

Najean Y, Rain JD, Billotey C (1997) The site of destruction of autologous mIn-labelled platelets and the efficiency of splenectomy in children and adults with idiopathic thrombocytopenic purpura: a study of 578 patients with 268 splenectomies. Br J Haematol 97: 547-50.

Peters AM, Swirsky DM (1998) Blood Disorders in Clinical Nuclear Medicine, 3rd edn (MN Maisey, KE Britton, BD Collier, eds), pp. 525-39. Chapman & Hall, London.

Peters AM, Saverymutti SH, Danpure HJ et al. (1986) Radionuclides in haematology: cell labelling. Methods Haematol 14: 70-109.

Peters AM, Saverymutti SH, Keshavarzian A et al. (1985) Splenic pooling of granulocytes. Clin Sci 68: 283-9.

Pickering J, Campbell H (2000) An audit of the vaccinations and antibiotic prophylaxis practices amongst patients splenectomised in Lothian. Health Bull 58: 390-5.

Pochedly C, Sills RH, Schwartz AD (1989) Disorders of the Spleen: Pathophysiology and Management. New York: Marcel Dekker.

Shadbolt C, Peters AM (2003) The spleen. In: Nuclear Medicine in Radiological Diagnosis (AM Peters, ed). Martin Dunitz, London.

Sty JR, Conway JJ (1985) The spleen: development and functional evaluation. Semin Nucl Med 15: 276-98.

Tham KT, Teague MW, Howard CA et al. (1996) A simple splenic reticuloendothelial function test. Am J Clin Pathol 105: 548-52.

Weiss L (1983) The red pulp of the spleen: structural basis of blood flow. Clin Haematol 12: 375-93.

Zhang B, Lewis SM (1983) Splenic haematocrit and the splenic plasma pool. Br J Haematol 66: 97-102.

Zhang B, Lewis SM (1987) Use of radionuclide scanning to estimate size of spleen in vivo. J Clin Pathol 40: 508-11.

Zhang B, Lewis SM (1989) A study of the reliability of clinical palpation ofthe spleen. Clin Lab Haematol 11: 7-10.

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