Keywords
splenic size
Ultrasonography
Abstract
Introduction: Sickle Cell Anaemia is the most
common genetic disease globally and is due to
replacement of glutamic acid with valine at position
6 of the Beta haemoglobin chain. This study aims to
describe the sonographic findings in the spleen of
patients with sickle cell anaemia and compare same
with those of the controls.
Methodology: A prospective, case-control study
conducted in University College Hospital Ibadan. One
hundred and twenty-eight consenting patients with
HbSS ages 2 to 60 years attending the adult and
children Haematology clinics were recruited while
128 HbAA healthy controls were recruited from the
general outpatient department. Patient’s
demographics, clinical history and ultrasound of the
spleen was performed and documented into the study
proforma.
Results: The mean splenic length in the cases and
controls were statistically significant (5.41 ± 4.28cm
vs 8.96 ± 1.51cm; p = 0.000). The mean splenic length
of SCA patients in the paediatrics age group was
4.43cm and adults was 4.38cm. Normal splenic size
(44.5%) was the most common in this study with
autosplenectomy seen only in 34.4% of all the SCA
patients studied. Abnormal splenic parenchymal
findings were observed in 22 (17.2%) of the cases
with only 4 (3.1%) seen in the control group and this
was statistically significant (p= 0.000).
Conclusion: This study demonstrated the use of
sonography as an invaluable imaging tool in the
assessment of the splenic size as well as its
parenchymal pattern and therefore recommends its
use for sickle cell anaemia patients in crises and / or
follow up.
References
Brown BJ, Fatunde OJ, Sodeinde O.
Correlates of steady-state haematocrit and
hepatosplenomegaly in children with sickle
cell disease in Western Nigeria. West Afr J
Med 2012;31(2):86–91.
Al-Salem AH. Splenic Complications of
Sickle Cell Anemia and the Role of
Splenectomy. ISRN Hematology. 2011. pp.
–7.
Gale HI, Bobbitt CA, Setty BN, Sprinz PG,
Doros G, Williams DD, et al. Expected
Sonographic Appearance of the Spleen in
Children and Young Adults With Sickle Cell
Disease: An Update. J Ultrasound Med
;35(8):1735–1745.
Facts | Sickle Cell Disease | NCBDDD |
CDC [Internet]. Available from: https://
www.cdc.gov/ncbddd/sicklecell/facts.html.
Assessed on 10/10/2017.
Lane PA. Sickle cell disease. Pediatr Clin
North Am. 1996;43(3):639–664.
World Health Organization Sickle-cell
anaemia Report by the Secretariat
Prevalence of sickle cell anaemia.2006;
Available from: http://apps.who.int/gb/
archive/pdf_files/WHA59/A59_9-en.pdf.
Assessed on 09/09/2019.
Babadoko A, Ibinaye P, Hassan A, Yusuf R,
Ijei I., Aiyekomogbon J, et al.
Autosplenectomy of Sickle Cell Disease in
Zaria, Nigeria: An Ultrasonographic
Assessment. Oman Med J. 2012;27(2):121–
Comparative analysis of Sonographic evaluation of the Spleen 293
Aliyu ZY, Tumblin AR, Kato GJ. Current
therapy of sickle cell disease.
Haematologica. 2006;91(1):7–10.
Akingbola TS, Kolude B, Aneni EC, Raji AA,
Iwara KU, Aken’Ova YA, et al.Abdominal
pain in adult sickle cell disease patients: a
Nigerian experience. Ann Ibadan Postgrad
Med. 2011;9(2):100–104.
Eze CU, Offordile GC, Agwuna KK, Ocheni
S, Nwadike IU, Chukwu BF. Sonographic
evaluation of the spleen among sickle cell
disease patients in a teaching hospital in
Nigeria. Afr Health Sci. 2015;15(3):949–958.
Ojo O, Shokunbi W, Agunloye A. Splenic size
in Sickle Cell Anaemia Patients in A Tertiary
Hospital. Nigerian Hospital Practice.
;13:82–87.
Attalla BI. Abdominal Sonographic Findings
in Children With Sickle Cell Anemia. Journal
of Diagnostic Medical Sonography.
;26:281–285.
Luntsi G, Eze C, Ahmadu M, Bukar A, Ochie
K. Sonographic evaluation of some
abdominal organs in sickle cell disease
patients in a tertiary health institution in
Northeastern Nigeria. J Med Ultrasound.
;26(1):31-36.
Charles Ugwoke E. Sonographic biometry
of spleen among school age children in
Nsukka, Southeast, Nigeria. Afr Health Sci.
;3(132):384–392.
Ezeike C. Ultrasonographic assessment
of the splenic size in sickle cell anemia:Single
splenic span mesurement vs splenic volume.
IJRSI. 2019;6(xii):77–83.
Olatunji AA, Olatunji PO. Splenic size
determination in sickle cell anaemia: an
ultrasonographic study. East Afr Med J.
;78(7):366–369.
Walczyk J, Walas MK. Errors made in the
ultrasound diagnostics of the spleen. J
Ultrason. 2013;13(52):65–72.
Ehimwenma O, Tagbo MT. Determination
of normal dimension of the spleen by
ultrasound in an endemic tropical
environment. Niger Med J . 2011;52(3):198–
Chow KU, Luxembourg B, Seifried E, Bonig
H. Spleen Size Is Significantly Influenced by
Body Height and Sex: Establishment of
Normal Values for Spleen Size at US with a
Cohort of 1200 Healthy Individuals.
Radiology. 2016;279(1):306–313.
Ugwu, Saad ST, Buba EA, Yuguda S, Ali
AM. Sonographic determination of liver and
spleen sizes in patients with sickle cell
disease at Gombe, Nigeria. Chrismed J
Health and Research. 2018;5(3):182-186.
Fasola FA, Adekanmi AJ. Haematological
Profile and Blood Transfusion Pattern of
Patients with Sickle Cell Anaemia vary with
Spleen Size. Ann Ibadan Postgrad Med.
;17(1):30–38.
Inah GB, Ekanem EE. Ultrasonographically
Determined Autosplenectomy Rates In
Nigerian Sicklers And The Predictors
Running Title: Splenic Changes In. J Dent
Med Sci. 2018;17(7):61–64.
Balci A, Karazincir S, Sangün O, Gali E,
Daplan T, Cingiz C, et al. Prevalence of
abdominal ultrasonographic abnormalities in
patients with sickle cell disease. Diagn Interv
Radiol. 2008;14(3):133–137.
Ahmed NHM, Mohammed AA, Mohammed
A, Elgyoum A, Hassan N, Ahmed M.
Evaluation of Abdominal Organs in Children
with Sickle Cell Anemia using
Ultrasonography. Sch J Appl Med Sci.
;5(3):920–925.
Al-Salem AH, Al-Aithan S, Bhamidipati P,
Al-Jam’a A, Al Dabbous I. Sonographic
assessment of spleen size in Saudi patients
with sickle cell disease. Ann Saudi Med.
;18(3):217–220.
Kaushal DL, Verma DVK, Ahirwar DCP,
Patil DA, Pratap Singh DS. Sonographic
evaluation of abdominal organs in a sickle
cell disease patient. Int J Med Res Rev.
;2(3):202–208.
Wilson-Okoh DA, Nwauche CA, Ejele OA.
Splenic changes in sickle cell anaemia. Niger
J Med;2006;15(1):20–23.