The influence of spleen size on the distribution of red cells and plasma

Toghill, P J; Green, Sheila

doi:10.1136/jcp.25.7.570

Cited by 10 publications

(5 citation statements)

References 14 publications

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“…With gross enlargement of the spleen in chronic liver disease a large pool of erythrocytes may be sequestered in the spleen thus reducing the effective extrasplenic red cell volume (Donaldson, McArthur, MacPherson, and Richmond, 1970). Finally there is the possibility that the splenic enlargement per se might be associated with an expansion of the plasma volume to give a haemodilutional anaemia (Toghill and Green, 1972).…”

Section: Discussionmentioning

confidence: 99%

“…Haematocrit levels were determined in duplicate with Wintrobe tubes, allowance being made for plasma trapping (Chaplin and Mollison, 1952). Erythrocytes were labelled with 80-100 ,uCi sodium chromate (Na251CrO4) and measurements of red cell mass and splenic red cell pool were made using themethods described earlier (Toghill and Green, 1972). The red cell survival was expressed as the time in days for 50% loss of 51Cr from the circulating red cells (Tso51Cr).…”

Section: Methodsmentioning

confidence: 99%

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Haematological changes in active chronic hepatitis with reference to the role of the spleen.

Toghill¹,

Green²

1975

J Clin Pathol

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The haematological role of the spleen has been investigated in a series of 22 patients with active chronic hepatitis. Severe pancytopenia occurred in one patient after three years of steroid therapy and this episode was associated with an increase in spleen size and a high splenic index of red cell destruction. Although the spleen was usually enlarged in the remainder of treated and untreated patients no others showed increased splenic haemolysis. The red cell survival was slightly reduced in most patients but splenic pooling of red cells and expansion of the plasma volume did not significantly reduce the haematocrit level. No consistent haematological differences were detected between the untreated and the treated patients.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Haematological changes in active chronic hepatitis with reference to the role of the spleen.

Toghill¹,

Green²

1975

J Clin Pathol

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“…In reports of two groups of patients with miscellaneous disor ders associated with splenomegaly a statistical relationship has been es Discussion tablished between pool size and spleen size [4,12]. However, P ettit et al [8], who measured total splenic red cell content, found it to be less in the lympho-proliferative disorders as compared with the myelo-proliferative diseases and regarded this as being due to replacement of the splenic cords by lymphoid tumour tissue.…”

Section: Splenic Pool Size In Myelo-and Lympho-proliferative Syndromesmentioning

confidence: 99%

Factors Influencing Splenic Pooling of Erythrocytes in the Myelo- and Lympho-Proliferative Syndromes

Toghill¹,

Green²

1973

Acta Haematol

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The splenic pool size has been measured in 50 patients with splenomegaly due to myelo- and lympho-proliferative disorders. Splenic pool size was related primarily to spleen size and was not significantly influenced by the pathological disorder. Changes in spleen size due to treatment or progressive disease altered the pool size. The splenic pool could be discharged with adrenaline and noradrenaline.

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“…It is possible that other factors associated with high‐altitude ascent influenced the spleen size reductions. For example, both plasma volume and nitric oxide change with ascent to high altitude (Beall et al., 2012 ; West, 2004 ), both of which have been found to influence spleen size at sea‐level (Engan et al., 2020 ; Toghill & Green, 1972 ).…”

Section: Introductionmentioning

confidence: 99%

Differential splenic responses to hyperoxic breathing at high altitude in Sherpa and lowlanders

Holmström,

Harman,

Kalker

et al. 2024

Experimental Physiology

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The human spleen contracts in response to stress‐induced catecholamine secretion, resulting in a temporary rise in haemoglobin concentration ([Hb]). Recent findings highlighted enhanced splenic response to exercise at high altitude in Sherpa, possibly due to a blunted splenic response to hypoxia. To explore the potential blunted splenic contraction in Sherpas at high altitude, we examined changes in spleen volume during hyperoxic breathing, comparing acclimatized Sherpa with acclimatized individuals of lowland ancestry. Our study included 14 non‐Sherpa (7 female) residing at altitude for a mean continuous duration of 3 months and 46 Sherpa (24 female) with an average of 4 years altitude exposure. Participants underwent a hyperoxic breathing test at altitude (4300 m; barrometric pressure = ∼430 torr; = ∼90 torr). Throughout the test, we measured spleen volume using ultrasonography and monitored oxygen saturation (). During rest, Sherpa exhibited larger spleens (226 ± 70 mL) compared to non‐Sherpa (165 ± 34 mL; P < 0.001; effect size (ES) = 0.95, 95% CI: 0.3–1.6). In response to hyperoxia, non‐Sherpa demonstrated 22 ± 12% increase in spleen size (35 ± 17 mL, 95% CI: 20.7–48.9; P < 0.001; ES = 1.8, 95% CI: 0.93–2.66), while spleen size remained unchanged in Sherpa (−2 ± 13 mL, 95% CI: −2.4 to 7.3; P = 0.640; ES = 0.18, 95% CI: −0.10 to 0.47). Our findings suggest that Sherpa and non‐Sherpas of lowland ancestry exhibit distinct variations in spleen volume during hyperoxia at high altitude, potentially indicating two distinct splenic functions. In Sherpa, this phenomenon may signify a diminished splenic response to altitude‐related hypoxia at rest, potentially contributing to enhanced splenic contractions during physical stress. Conversely, non‐Sherpa experienced a transient increase in spleen size during hyperoxia, indicating an active tonic contraction, which may influence early altitude acclimatization in lowlanders by raising [Hb].

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The influence of spleen size on the distribution of red cells and plasma

Cited by 10 publications

References 14 publications

Haematological changes in active chronic hepatitis with reference to the role of the spleen.

Haematological changes in active chronic hepatitis with reference to the role of the spleen.

Factors Influencing Splenic Pooling of Erythrocytes in the Myelo- and Lympho-Proliferative Syndromes

Differential splenic responses to hyperoxic breathing at high altitude in Sherpa and lowlanders

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