Spleen size in patients with celiac disease - prospective study



Year of publication 2010
Type Appeared in Conference without Proceedings
MU Faculty or unit

Faculty of Medicine

Description Purpose: There are some studies dealing with hyposplenism by patients with celiac disease (CD). The atrophy of the spleen is associated with hyposplenism. Hyposplenism is not a rare condition and can complicate a remarkable number of illnesses. The two most time-honored diseases associated with the development of hyposplenism are sickle cell anemia and celiac disease. Hyposplenism is relatively easy to recognize by typical changes observed on the peripheral blood smear; including Howell-Jolly bodies, monocytosis, lymphocytosis, and increased platelet counts. Diagnosis can be confirmed by pitted RBC counts or 99Tc-labelled radiocolloid scan of the spleen; wherever available. The aim of our study was to demonstrate the atrophy of the spleen on the basis of the measurement by ultrasound by patients with CD. Methods and Materials: Two groups of patients were examined between January 2008-August 2009. The first group consisted of 100 healthy adult patients. Next 100 adult patients in the second group were patients with verified CD without associated disorders. Because of statistically significant difference in age distribution between our two groups, we selected randomly two age-matching subgroups of patients (each N=23) with age between 10 and 60 years (Mann Whitney U-test, p=0.896). We applied measurement of the spleen size in all patients using ultrasound machine Philips iU22. The interests of the measurement were longitudinal diameter and width at the hilus level. We established the normal spleen size based on the arguments in literature. Fisher exact test (for analysis of two-way contingency tables) was performed to compare distribution of spleen size between those two groups. Results: There is statistically significant difference in the spleen size (p< 0.001) between our two groups. Patients in the first group with verified CD have more frequently reduced spleen size (78.3%) than healthy patients (26.1%) in the second group. Similarly there is statistically significant difference in the spleen size (p=0.002) between the group of healthy patients (26.1|%) and the group with suspicion of the CD (75.0%). Conclusion: We managed to extend the association between hyposplenism and spleen size by patients with CD.
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