Prevalence of Howell-Jolly Bodies Caused by Partial Splenic Embolization for Portal Hypertension
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概要
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Objective Postsplenectomy sepsis (PSS) and overwhelming postsplenectomy infection (OPSI) following splenectomy or the development of hyposplenism are associated with a high mortality rate. The presence of Howell-Jolly bodies (HJBs) in peripheral erythrocytes is attracting attention as a parameter of hyposplenism. To date, whether HJBs appear following partial splenic embolization (PSE) has not been investigated. Therefore, we examined the prevalence of HJBs in patients who have undergone PSE. Methods Whether HJBs were present in 95 patients who underwent PSE between November 2007 and August 2012 was assessed. Results No serious complications occurred due to PSE; however, 17 of the 95 patients (17.89%) exhibited HJBs during the follow-up. The residual spleen volume and splenic infarction rate did not differ significantly compared to those observed in the HJB-negative group. Conclusion With the recent increase in the use of autoanalyzers, the opportunities to perform microscopic examinations have been decreasing. Therefore, the presence of HJBs, which can only be confirmed visually, may be overlooked, and the clinical significance of these bodies tends to be disregarded. However, the presence of HJBs is associated with a risk of PSS and OPSI due to hyposplenism. Because HJBs are common in the peripheral erythrocytes of patients who have undergone PSE, irrespective of the residual spleen volume or splenic infarction rate, the presence or absence of HJBs should be assessed visually. In HJB-positive patients, preventing serious infections, for example, by administering the pneumococcal vaccine, is important.
著者
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Yoshida Toshiaki
Department Of Cardiovascular Medicine Graduate School Of Medical Scences Kumamoto University
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Honda Hiroki
Department Of Electrical Engineering Kyoto University:(present Address)mitsubishi Electric Corporati
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Ishikawa Toru
Department Of Gastroenterology And Hepatology Saiseikai Niigata Second Hospital
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Kubota Tomoyuki
Department Of Biology Faculty Of Science Kagoshima University
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Honma Terasu
Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Japan
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Horigome Ryoko
Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Japan
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Kimura Naruhiro
Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Japan
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Iwanaga Akito
Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Japan
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Seki Keiichi
Department of Gastroenterology and Hepatology, Saiseikai Niigata Daini Hospital, Japan
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