OBJECTIVE: To evaluate the frequency of infectious complications in children with sickle
cell disease (SCD) after surgical splenectomy for acute splenic sequestration
crisis. METHODS: Retrospective cohort of children with SCD who were born after 2002 and were
regularly monitored until July 2013. Patients were divided into two groups: cases
(children with SCD who underwent surgical splenectomy after an episode of splenic
sequestration) and controls (children with SCD who did not have splenic
sequestration and surgical procedures), in order to compare the frequency of
invasive infections (sepsis, meningitis, bacteremia with positive blood cultures,
acute chest syndrome and/or pneumonia) by data collected from medical records.
Data were analyzed by descriptive statistical analysis. RESULTS: 44 patients were included in the case group. The mean age at the time of
splenectomy was 2.6 years (1-6.9 years) and the mean postoperative length of
follow-up was 6.1 years (3.8-9.9 years). The control group consisted of 69
patients with a mean age at the initial follow-up visit of 5.6 months (1-49
months) and a mean length of follow-up of 7.2 years (4-10.3 years).All children
received pneumococcal conjugate vaccine. No significant difference was observed
between groups in relation to infections during the follow-up. CONCLUSIONS: Surgical splenectomy in children with sickle cell disease that had splenic
sequestration did not affect the frequency of infectious complications during 6
years of clinical follow-up.
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