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Have chrohns disease and enlarged spleen. What medication is used?

I have crohns disease for 17 years and recently learned I have an enlarged spleen . With long term anemia , crohns and the medications I have to take, it has given me abnormal blood levels when they take cbc and various blood tests. For this reason they are going to monitor the spleen and the levels before deciding if they need to remove it, if it may be cancerous, or fairly harmless. All the tests on my liver were good and they have ruled out my liver causing my spleen to enlarge. I have heard removal of the spleen leads to a higher chance of infection and a tougher time to fight bacteria, infection etc. What type of medications are used for people who have their spleen removed and will removing my spleen, put my body in a very compromising position since Im taking medications like Humira, Immuran, predisone and my immune system is pretty much shut off? I know I dont need to worry about the worse case scenario yet, Im just concerned if they remove my spleen I will either spend a lot more time in and out of the hospital or I will have to isolate myself even more due to increase risk of infection . Im curious about the quality of life a person with severe crohns disease taking immune lowering medications and has their spleen removed?
Wed, 30 Aug 2017
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General Surgeon 's  Response
Hi there,

First of all, let me assure you that many patients have their spleen removed, even in the setting of being immunocompromised and don't offer any ill effects. You are correct in that you have a greater risk of post splenectomy sepsis, but typically in elective splenectomy (planned removal of the spleen) we give 3 vaccines that offset this risk - Hemophaulis influenza, Streptoccoccus pneumonia, and Neisseria. I believe that you have to have these vaccines repeated every 5 years, and that should cover you for the organisms that could cause infection without a spleen.

You shouldn't have to isolate yourself or take any special precautions after your spleen is removed, as long as you keep up with your vaccines. Your quality of life should be unchanged, and most surgeons in the US will do these procedure laparoscopically, meaning it should be done with small incisions.

I hope I have answered your questions. Please feel free to contact me if you have any further questions or if you feel I haven't addressed your question adequately.
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