|
|
(6 intermediate revisions by one other user not shown) |
Line 10: |
Line 10: |
| '''For patient information click [[Hereditary spherocytosis (patient information)|here]]''' | | '''For patient information click [[Hereditary spherocytosis (patient information)|here]]''' |
|
| |
|
| {{CMG}} {{ZAS}} | | {{CMG}}; {{AE}} {{ZAS}} |
|
| |
|
| ==[[Hereditary spherocytosis overview|Overview]]== | | ==[[Hereditary spherocytosis overview|Overview]]== |
| '''Hereditary spherocytosis''' is a genetically-transmitted form of [[spherocytosis]], an auto-[[Hemolysis|hemolytic]] [[anemia]] characterized by the production of red blood cells that are sphere-shaped rather than donut-shaped, and therefore more prone to [[hemolysis]].
| |
|
| |
|
| == [[hereditary spherocytosis historical perspective|Historical Perspective]] == | | == [[hereditary spherocytosis historical perspective|Historical Perspective]] == |
Line 40: |
Line 39: |
|
| |
|
| == [[hereditary spherocytosis laboratory findings|Laboratory Findings]] == | | == [[hereditary spherocytosis laboratory findings|Laboratory Findings]] == |
| | |
| | == [[hereditary spherocytosis chest x ray|Chest X ray]] == |
| | |
| | == [[hereditary spherocytosis CT|CT]] == |
| | |
| | == [[hereditary spherocytosis MRI|MRI]] == |
| | |
| | == [[hereditary spherocytosis echocardiography or ultrasound| Echocardiography or Ultrasound]] == |
| | |
| | == [[hereditary spherocytosis other imaging findings|Other Imaging Findings]] == |
| | |
| | == [[hereditary spherocytosis other diagnostic studies|Other Diagnostic Studies]] == |
|
| |
|
| == [[hereditary spherocytosis medical therapy|Treatment]] == | | == [[hereditary spherocytosis medical therapy|Treatment]] == |
|
| |
|
| == [[hereditary spherocytosis medical therapy|Medical Therapy]] == | | == [[hereditary spherocytosis medical therapy|Medical Therapy]] == |
| * There is no specific medical therapy for hereditary spherocytosis. As the diagnosis of hereditary spherocytosis is made, surveillance is needed to help detect and manage any complications.<ref name="Bolton-MaggsStevens2004">{{cite journal|last1=Bolton-Maggs|first1=P. H. B.|last2=Stevens|first2=R. F.|last3=Dodd|first3=N. J.|last4=Lamont|first4=G.|last5=Tittensor|first5=P.|last6=King|first6=M.-J.|title=Guidelines for the diagnosis and management of hereditary spherocytosis|journal=British Journal of Haematology|volume=126|issue=4|year=2004|pages=455–474|issn=0007-1048|doi=10.1111/j.1365-2141.2004.05052.x}}</ref>
| |
|
| |
| * A routine annual review is usually sufficient to detect any complications such as parvovirus infection or abdominal pain which may necessitate the investigation for gallstones.
| |
| * Folate supplementation is not always required, but is used as a routine for children with severe hemolysis and in pregnancy, regardless of severity of hereditary spherocytosis.<ref>{{Cite journal
| |
| | author = [[P. H. B. Bolton-Maggs]]
| |
| | title = Hereditary spherocytosis; new guidelines
| |
| | journal = [[Archives of disease in childhood]]
| |
| | volume = 89
| |
| | issue = 9
| |
| | pages = 809–812
| |
| | year = 2004
| |
| | month = September
| |
| | doi = 10.1136/adc.2003.034587
| |
| | pmid = 15321852
| |
| }}</ref>
| |
|
| |
|
| == [[hereditary spherocytosis surgery|Surgery]] == | | == [[hereditary spherocytosis surgery|Surgery]] == |
| * Splenectomy is very effective in reducing hemolysis, leading to significant prolongation of the red cell life span.<ref>{{Cite journal
| |
| | author = [[P. H. B. Bolton-Maggs]], [[R. F. Stevens]], [[N. J. Dodd]], [[G. Lamont]], [[P. Tittensor]] & [[M.-J. King]]
| |
| | title = Guidelines for the diagnosis and management of hereditary spherocytosis
| |
| | journal = [[British journal of haematology]]
| |
| | volume = 126
| |
| | issue = 4
| |
| | pages = 455–474
| |
| | year = 2004
| |
| | month = August
| |
| | doi = 10.1111/j.1365-2141.2004.05052.x
| |
| | pmid = 15287938
| |
| }}</ref><ref name="CasalePerrotta2014">{{cite journal|last1=Casale|first1=Maddalena|last2=Perrotta|first2=Silverio|title=Splenectomy for hereditary spherocytosis: complete, partial or not at all?|journal=Expert Review of Hematology|volume=4|issue=6|year=2014|pages=627–635|issn=1747-4086|doi=10.1586/ehm.11.51}}</ref>
| |
| * Patients should be selected for splenectomy on the basis of their clinical symptoms and presence of complications such as gallstones, not simply on the basis of diagnosis alone.
| |
| * Following splenectomy, the clinical manifestations and complications (anemia & gallstones) are much reduced in severe hereditary spherocytosis and abolished in milder cases, but at the risk of increased life threatening sepsis from encapsulated organisms, particularly streptococcus pneumoniae.<ref name="Bolton-MaggsStevens2004">{{cite journal|last1=Bolton-Maggs|first1=P. H. B.|last2=Stevens|first2=R. F.|last3=Dodd|first3=N. J.|last4=Lamont|first4=G.|last5=Tittensor|first5=P.|last6=King|first6=M.-J.|title=Guidelines for the diagnosis and management of hereditary spherocytosis|journal=British Journal of Haematology|volume=126|issue=4|year=2004|pages=455–474|issn=0007-1048|doi=10.1111/j.1365-2141.2004.05052.x}}</ref><ref>{{Cite journal
| |
| | author = [[Sayeeda Huq]], [[Mark A. C. Pietroni]], [[Hafizur Rahman]] & [[Mohammad Tariqul Alam]]
| |
| | title = Hereditary spherocytosis
| |
| | journal = [[Journal of health, population, and nutrition]]
| |
| | volume = 28
| |
| | issue = 1
| |
| | pages = 107–109
| |
| | year = 2010
| |
| | month = February
| |
| | pmid = 20214092
| |
| }}</ref>
| |
| * Children or young adults with mild hereditary spherocytosis who also has gallstones are likely to benefit from combined splenectomy and cholecystectomy in terms of life expectancy.<ref name="Bolton-MaggsStevens2004">{{cite journal|last1=Bolton-Maggs|first1=P. H. B.|last2=Stevens|first2=R. F.|last3=Dodd|first3=N. J.|last4=Lamont|first4=G.|last5=Tittensor|first5=P.|last6=King|first6=M.-J.|title=Guidelines for the diagnosis and management of hereditary spherocytosis|journal=British Journal of Haematology|volume=126|issue=4|year=2004|pages=455–474|issn=0007-1048|doi=10.1111/j.1365-2141.2004.05052.x}}</ref>
| |
|
| |
|
| ==[[hereditary spherocytosis primary prevention|Primary Prevention]] == | | ==[[hereditary spherocytosis primary prevention|Primary Prevention]] == |
| * The administration of vaccines (pneumococcal, haemophilus influenzae type b, meningococcal group C and influenza) is indicated 2 to 3 weeks before splenectomy.<ref>{{Cite journal
| |
| | author = [[Sayeeda Huq]], [[Mark A. C. Pietroni]], [[Hafizur Rahman]] & [[Mohammad Tariqul Alam]]
| |
| | title = Hereditary spherocytosis
| |
| | journal = [[Journal of health, population, and nutrition]]
| |
| | volume = 28
| |
| | issue = 1
| |
| | pages = 107–109
| |
| | year = 2010
| |
| | month = February
| |
| | pmid = 20214092
| |
| }}</ref>
| |
| * Postsplenectomy patients should also be given 1mg of folic acid daily for preventing secondary folic acid deficiency and oral penicillin (penicillin V) for preventing secondary infection until reaching adulthood.
| |
|
| |
|
| == [[hereditary spherocytosis secondary prevention|Secondary Prevention]]== | | == [[hereditary spherocytosis secondary prevention|Secondary Prevention]]== |
| | |
| | == [[hereditary spherocytosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] == |
| | |
| | == [[hereditary spherocytosis future or investigational therapies|Future or Investigational Therapies]] == |
|
| |
|
| == [[Hereditary spherocytosis case study one|Case Studies]] == | | == [[Hereditary spherocytosis case study one|Case Studies]] == |