Sonographic determination of liver and spleen sizes in patients with sickle cell disease at Gombe, Nigeria
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Background Ultrasonography is an established and reliable method for assessing the spleen. Because of variation due to genetic and other environmental factors including malaria endemicity, interpretation of splenic sizes requires a knowledge of the normal reference range for a given population. The aim of this study was to determine spleen size in different age groups among healthy people in North-Eastern Nigeria and use this as a reference to determine spleen size amongst sickle cell disease (SCD) patients. Methods Using a cross-sectional study design, spleen size was measured in healthy people of different age groups, and steady-state SCD patients (children and adults) using abdominal ultrasonography. Using the age-group specific reference values obtained from the controls, spleens were classified into small, normal size, or enlarged among the SCD patients. Results Abdominal ultrasonography was performed for 313 participants, comprising 109 (34.8%) healthy controls and 204 (65.2%) steady-state SCD patients. The spleen was visualized in all the controls. However, 97(47.6%) of the SCD patients had no visible spleen. Small, normal, and enlarged spleens were observed in 16.7% (n=18/107), 63.6% (n=68/107) and 19.6% (n=21/107) SCD patients, respectively. Compared to the control group, splenic length was three-fold higher in the first two years of life in SCD patients, followed by a progressive age-related decline in size. Enlarged spleens were detected among 5(2.4%) SCD patients by manual palpation method compared to 21 (19.6%) using ultrasonography. Conclusion Model-based age-specific reference ranges and percentile curves for splenic dimensions based on ultrasonography among normal controls in North-Eastern Nigeria were established and may be of value in assessing spleen sizes among SCD patients living in malaria-endemic regions of Africa. Regular spleen scans to assess changes in size can help identify SCD patients at risk of splenomegaly complications including subclinical acute sequestration and hypersplenism, and those who are developing splenic atrophy.
Background Ultrasonography is an established and reliable method for assessing the spleen. Because of variation due to genetic and other environmental factors including malaria endemicity, interpretation of splenic sizes requires a knowledge of the normal reference range for a given population. The aim of this study was to determine spleen size in different age groups among healthy people in North-Eastern Nigeria and use this as a reference to determine spleen size amongst sickle cell disease (SCD) patients. Methods Using a cross-sectional study design, spleen size was measured in healthy people of different age groups, and steady-state SCD patients (children and adults) using abdominal ultrasonography. Using the age-group specific reference values obtained from the controls, spleens were classified into small, normal size, or enlarged among the SCD patients. Results Abdominal ultrasonography was performed for 313 participants, comprising 109 (34.8%) healthy controls and 204 (65.2%) steady-state SCD patients. The spleen was visualized in all the controls. However, 97(47.6%) of the SCD patients had no visible spleen. Small, normal, and enlarged spleens were observed in 16.7% (n=18/107), 63.6% (n=68/107) and 19.6% (n=21/107) SCD patients, respectively. Compared to the control group, splenic length was three-fold higher in the first two years of life in SCD patients, followed by a progressive age-related decline in size. Enlarged spleens were detected among 5(2.4%) SCD patients by manual palpation method compared to 21 (19.6%) using ultrasonography. Conclusion Model-based age-specific reference ranges and percentile curves for splenic dimensions based on ultrasonography among normal controls in North-Eastern Nigeria were established and may be of value in assessing spleen sizes among SCD patients living in malaria-endemic regions of Africa. Regular spleen scans to assess changes in size can help identify SCD patients at risk of splenomegaly complications including subclinical acute sequestration and hypersplenism, and those who are developing splenic atrophy.
Ultrasonographic assessment of spleen size and pattern of change among sickle cell disease patients and healthy controls in North-Eastern Nigeria
Background: Ultrasonography is an established and reliable method for assessing the spleen. Because of variation due to genetic and other environmental factors including malaria endemicity, interpretation of spleen sizes requires a knowledge of the normal reference range for a given population. This study aimed to identify spleen size reference ranges across age groups of healthy controls to serve as a baseline to assess changes in spleen size in patients with sickle cell disease. Methods: Using a cross-sectional study design, spleen size was measured in healthy people of different age groups and steady-state sickle cell disease patients (children and adults) using abdominal ultrasonography. Using the age-group-specific reference values obtained from the controls, spleens were classified into small, normal size or enlarged among the sickle cell disease patients. Results: The study consisted of 109 (34.8%) healthy controls and 204 (65.2%) steady-state sickle cell disease patients. The spleen was visualised in all the controls ( n = 109) and in 107 (52.4%) sickle cell disease patients. Using cut-off values for spleen length among the controls across age groups (< 5 years (5.0–7.0 cm); 5–9 years (5.5–8.5 cm); 10–14 years (6.0–11.0 cm) and ⩾ 15 years (7.0–12.5 cm)), spleen size was classified as small ( n = 18/204; 8.87%), normal ( n = 68/204; 33.3%) and enlarged ( n = 21/204; 10.3%) among the sickle cell disease patients. Conclusion: Model-based age-group reference ranges and percentile curves for splenic dimensions based on ultrasonography among normal controls in North-Eastern Nigeria were established and may be of value in assessing spleen sizes among sickle cell disease patients living in malaria-endemic regions of Africa.
Sonographic Assessment of Splenic Manifestations in Sickle Cell Disease Patients and Its Relation to Hematological Parameters: A Cross-Sectional Study in Basra, Iraq
Background Hemoglobinopathies, such as sickle cell disease (SCD), are inherited disorders of hemoglobin (Hb) synthesis. SCD presents with complex clinical manifestations, including anemia, painful episodes, and organ damage due to recurrent vaso-occlusion. The spleen is one of the first organs affected in SCD patients, with hyposplenism typically occurring by age five. However, older patients may show variations in splenic size, which can complicate the diagnosis. Objective This study aimed to investigate the radiological manifestations of the spleen in patients with SCD using sonographic assessment and the relationship between these manifestations and the patient's clinical and laboratory findings. Methodology This descriptive cross-sectional study was carried out at the Basra Hematology Center, which is the largest center for hematological diseases in the southern part of Iraq. It was carried out over a three-month period from May 22 to August 22, 2024. A total of 81 patients aged 15 and above, diagnosed with SCD, and attending the outpatient clinic at Basra Hematology Center in Basra city were included. Participants were identified through medical records and referrals from private outpatient clinics. Inclusion criteria ensured participants had a confirmed SCD diagnosis and met the age requirements. Exclusion criteria eliminated individuals with sickle cell trait, other hemolytic anemias, leukemia, relevant co-morbidities, or those who declined participation. After obtaining informed consent, each patient was interviewed by the research team, their blood was taken for lab tests, and then an ultrasound scan of their spleen was performed. Results Regarding the demographic characteristics of patients, age showed a statistically significant difference across the groups (p=0.017), indicating that marked splenomegaly is associated with younger individuals (mean age of 19.50 ± 4.95 years) compared to autosplenectomy, which is linked to older patients (mean age of 35.42 ± 11.84 years). Regarding radiological findings, splenic size was categorized into normal size, splenomegaly, small spleen, and autosplenectomy. Increased echogenicity is more frequently seen in the small spleen group (87.5%, p<0.001). Focal lesions, such as infarctions, were relatively uncommon and did not show significant variation across the groups. However, the presence of Gamna-Gandy bodies (GGB) was reported in a few patients and did not vary significantly among spleen status groups. The laboratory data showed notable significant differences in several key blood parameters. Hb levels were significantly lower in patients with marked splenomegaly (6.65 ± 0.21 g/dl) compared to other groups (p=0.01). White blood cell count (WBC) and platelet count (PLT) were significantly higher in the autosplenectomy group (WBC 12.29 ± 5.67 x 10³/μL; PLT 426.16 ± 222.85 x 10³/μL), both with p-values <0.001. Conclusion This study examined splenic changes in SCD p...
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