In which of the following conditions is splenectomy typically NOT recommended as a primary treatment option:
A. Idiopathic thrombocytopenic purpura
B. Congenital spherocytosis
C. Autoimmune haemolytic anemia
D. Vascular purpura
E. Hypersplenism
Answer:
D. Vascular purpura
Explanation:
Splenectomy is recommended in various medical conditions when other treatments have failed or when it is deemed necessary to address the underlying issue. However, splenectomy is typically not indicated in cases of vascular purpura (Option D). Vascular purpura usually involves issues with blood vessels and is not a condition where removing the spleen is the primary treatment approach. The other conditions listed, such as idiopathic thrombocytopenic purpura (ITP), congenital spherocytosis, autoimmune hemolytic anemia, and hypersplenism, may benefit from splenectomy when conservative treatments have not been effective.
Certainly, let’s explain each point in detail:
A. Idiopathic Thrombocytopenic Purpura (ITP):
- ITP is an autoimmune disorder characterized by a low platelet count, leading to an increased risk of bleeding and easy bruising.
- In ITP, the spleen often plays a significant role in the destruction of platelets. Removing the spleen (splenectomy) is a treatment option when other treatments fail to raise platelet counts.
- Splenectomy can stop the destruction of platelets within the spleen, allowing platelet counts to increase.
B. Congenital Spherocytosis:
- Congenital spherocytosis is a hereditary condition in which red blood cells have a spherical shape, making them more fragile and prone to destruction, leading to anemia and jaundice.
- Splenectomy is often recommended in congenital spherocytosis to alleviate the symptoms by removing the site of excessive red blood cell destruction, which is primarily the spleen.
C. Autoimmune Hemolytic Anemia:
- Autoimmune hemolytic anemia (AIHA) is a condition in which the immune system attacks and destroys red blood cells, leading to anemia and jaundice.
- Splenectomy is considered in cases of AIHA when the condition is refractory to other treatments. The spleen is often the primary site of red blood cell destruction.
D. Vascular Purpura:
- Vascular purpura usually involves issues with blood vessels, such as fragility or inflammation, leading to bleeding into the skin and mucous membranes.
- Splenectomy is generally not indicated for vascular purpura, as the condition is primarily related to blood vessel abnormalities rather than spleen dysfunction.