Blood, 1958, Vol. 13, No. 6, pp. 524-532.
© 1958 American Society of Hematology, Inc.
Observations on the Anemia of Cryptogenetic
Splenomegaly
II. Expansion of the Plasma Volume
A. J. S. MCFADZEAN 1,
DAVID TODD 1, and
K. C. TSANG 1
1 University Department of Medicine and Queen Mary Hospital, Hong Kong.
In cryptogenetic splenomegaly, although there is consistently a significant
reduction in hemoglobin concentration and in the red cell count, the total
red cell volume may be reduced, normal or increased.
Following splenectomy the total red cell volume is either within normal
limits or is increased, yet significant anemia persists.
Before splenectomy a significant increase in plasma volume is consistently
present. Following splenectomy the plasma volume falls, but it remains significantly greater than normal. It would appear that the greater the plasma
volume before splenectomy the greater is the fall following splenectomy.
This fall in plasma volume is not a prompt response to splenectomy, for the
fall which occurs one month after splenectomy is equalled or exceeded by
that occurring in the succeeding four months.
It is concluded that an expanded plasma volume before splenectomy contributes with the hemolysis previously reported to the development of the
anemia encountered in cryptogenetic splenomegaly. Expansion of the plasma
volume at least contributes to the anemia which persists following splenectomy.
Submitted on February 12, 1957
Accepted on December 25, 1957
