Haematological effects of splenectomy and hyposplenism

Red cell changes

The changes in red cell morphology include the presence of Howell-Jolly bodies and Pappenheimer (siderotic) granules in some cells. These red cell morphology may assist in the diagnosis of hyposplenism and evaluate residual or ectopic splenic function after splenectomy.

White cell changes

Postsplenectomy there is a mild permanent rise in both lymphocyte and monocyte count.

Platelet changes

The spleen normally pools up to a third of the circulating platelets. In the immediate period after a splenectomy, the platelet count rise steeply to levels of 600-1000 X 109/l. This thrombocytosis is usually temporary and fall to a level one-third higher than in normal subjects over the following 1-2 months. Occasional large and bizarre platelets can be seen in blood films.

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