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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is It Safe To Have Splenectomy For ITP?

I recently saw an article about a young, athletic boy who has ITP and is living with the ups and downs of a low platelet count. I am female, 51 yrs. old, and was diagnosed with ITP at 18 yrs. old. I did a 3 month diminishing steroid treatment, and then still had a lower than expected platelet count. I was told I had to have a splenectomy, which I did. My platelet count has been fine ever since, including thru 2 pregnancies. I have had timed bleeding tests to be certain that it would be safe for my children to be born naturally as well as while in labor, scalp samles from the child to make sure that the child's blood count was okay to continue with natural child birth. It was.



My question is this: Is there a reason why a doctor would not prescribe a splenectomy now for a male teenager with ITP? If so, are there health concerns that I need to know about being a person without a spleen for so many years?
Tue, 27 Jan 2015
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Geriatrics Specialist 's  Response
Hi,
Thanks for asking.
Based on your query, my opinion is as follows.
1. Spleen is an important organ in immune system, specifically against capsulated organisms.
2. In ITP, spleen is the site of destruction and hence its removal will improve platelets count.
3. Splenectomy increases risk of severe infection by capsulated organisms and usually is last resort treatment. Vaccination is available against these common capsulated organisms.
4. As the age is younger for the boy, the risk of infection is present for longer time, hence they are waiting and watching to check for progression. In the young, chronic ITP risk is low and acute ITP usually comes under control.
Hope it helps.
Any further queries, happy to help again.
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Is It Safe To Have Splenectomy For ITP?

Hi, Thanks for asking. Based on your query, my opinion is as follows. 1. Spleen is an important organ in immune system, specifically against capsulated organisms. 2. In ITP, spleen is the site of destruction and hence its removal will improve platelets count. 3. Splenectomy increases risk of severe infection by capsulated organisms and usually is last resort treatment. Vaccination is available against these common capsulated organisms. 4. As the age is younger for the boy, the risk of infection is present for longer time, hence they are waiting and watching to check for progression. In the young, chronic ITP risk is low and acute ITP usually comes under control. Hope it helps. Any further queries, happy to help again.