Blood, 1958, Vol. 13, No. 6, pp. 513-523.
© 1958 American Society of Hematology, Inc.
Observations on the Anemia of Cryptogenetic
Splenomegaly. I. Hemolysis
A. J. S. MCFADZEAN 1,
DAVID TODD 1, and
K. C. TSANG 1
1 University Department of Medicine and Queen Mary Hospital, Hong Kong.
Excessive hemolysis has been shown to occur in patients with cryptogenetic
splenomegaly. This is corrected by splenectomy.
The survival of normal red cells transfused to such patients is greatly
reduced. Following splenectomy normal red cells so transfused survive normally.
The survival of red cells from such patients upon transfusion to healthy
recipients, including a splenectomized recipient, is greatly reduced. Following splenectomy the survival of red cells from such patients upon transfusion to healthy recipients is significantly increased, although still significantly less than normal. However, upon transfusion into splenectomized but
otherwise healthy recipients the survival time is normal.
Study of osmotic fragility before splenectomy demonstrates the existence
of a mixed population showing both increased and decreased fragility to
hypotonic saline. Following splenectomy there emerges a population with
increased resistance to hypotonic saline.
It is concluded that prior to splenectomy the pathologic spleen exerts an
effect upon circulating erythrocytes including transfused normal red cells
which results in marked reduction in their survival. Following splenectomy
a second defect in the erythrocytes becomes apparent and this also results
in reduction in life-span, although the presence of the spleen would appear
necessary for this reduction to occur. It is suggested that this second defect
develops as the result of liver damage.
Submitted on February 12, 1957
Accepted on December 25, 1957
