Splenectomy: a strong risk factor for Pulmonary hypertension in Thalassemic patients

Arintaya Phrommintikul ^1*, Apichard Sukonthasarn ¹, Rungsrit Kanjanavanit ¹ and Weerasak Nawarawong ¹

¹ Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Thailand

^* To whom correspondence should be addressed. E-mail: apromint{at}mail.med.cmu.ac.th.

Accepted 24 March 2006

Abstract

Objective: To determine the association between splenectomy and pulmonary hypertension in Thalassemic patients with anemia

Design: Prospective cross-sectional study

Methods: Sixty eight thalassemic patients, who had a hemoglobin level of less than 10g/dl were recruited into this study. Echocardiogram was performed before reviewing the clinical data. Pulmonary artery pressure was estimated by measuring the systolic transtricuspid pressure gradient of tricuspid regurgitation and adding to the right atrial pressure, which was estimated by the response of inferior vena cava to deep inspiration. Pulmonary hypertension was defined as systolic pulmonary artery pressure >35 mmHg. History of splenectomy and other clinical data were compared between those with and without pulmonary hypertension.

Results: There were 29 patients with and 39 without pulmonary hypertensions. The pulmonary hypertensive patients had a significantly greater number of nucleated red blood cells and platelet counts and a higher prevalence of splenectomy (75.8 percent vs. 25.6 percent, p <0.001). The odds ratio for splenectomy in patients with pulmonary hypertension was 9.1 (95% CI, 3.0-27.7) compared to the patients without pulmonary hypertension. With multivariate analysis, splenectomy stood out as the only factor significantly related to pulmonary hypertension.

Conclusion: Our findings indicate that splenectomy is a strong risk factor for pulmonary hypertension in thalassemic patients.

Keywords: pulmonary hypertension, splenectomy, thalassemia

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Thachil, J. (2009). The enigma of pulmonary hypertension after splenectomy--does the megakaryocyte provide a clue?. QJM 102: 743-745 [Abstract] [Full Text]  
• Crary, S. E., Buchanan, G. R. (2009). Vascular complications after splenectomy for hematologic disorders. Blood 114: 2861-2868 [Abstract] [Full Text]  
• Pashankar, F. D., Carbonella, J., Bazzy-Asaad, A., Friedman, A. (2008). Prevalence and Risk Factors of Elevated Pulmonary Artery Pressures in Children With Sickle Cell Disease. Pediatrics 121: 777-782 [Abstract] [Full Text]  
• Vichinsky, E. (2007). Hemoglobin E Syndromes. ASH Education Book 2007: 79-83 [Abstract] [Full Text]