Splenectomy and its relation to non-transfusion-transmitted infection in thalassemic patients

Mururul Aisyi; Alan Roland Tumbelaka; Bulan Ginting Munthe; Bambang Madiyono

doi:10.14238/pi46.3.2006.134-8

Mururul Aisyi
Alan Roland Tumbelaka
Bulan Ginting Munthe
Bambang Madiyono

DOI: https://doi.org/10.14238/pi46.3.2006.134-8

Keywords: splenectomy, thalassemia, non transfusion-transmitted infection, risk factors, mild infection

Abstract

Background Splenectomy has been associated with an increased
susceptibility to infection. Overwhelming postspelenectomy infec-
tion (OPSI) can lead to high mortality. Decreased IgM and tuftsin
concentration on splenectomized patients seems to play a role in
infectionâ€™s susceptibility. Many studies have been performed to
determine the risk factors of infection in thalassemic patients.
Objective To find out morbidity patterns and risk factors for pre-
dicting the likelihood of infection in splenectomized thalassemic
patients.
Methods A retrospective cross sectional study was conducted on
confirmed thalassemic children who came to Department of Child
Health, Cipto Mangunkusumo Hospital within the period of 1973-
2003. Splenectomized patients were categorized as cases group
and non-splenectomized patients as control group. Risk factors for
development of common cold and diarrhea were analyzed using
chi-square test with level of significance <0.05.
Results A total of 300 thalassemic patients, 100 of them were sple-
nectomized, were enrolled in this study. The 15-year-age group or
above is the most common group underwent splenectomy (35%).
Common cold is the most common mild infection in both splenec-
tomized group (75%) and non-splenectomized (71%). A significant
association was found between the risk of infection and splenec-
tomy in thalassemic patients (OR=3.8;CI=2.2;6.62; P=0.000). As-
sociation between time after splenectomy and frequency of com-
mon cold in thalassemia was significant (OR=2.85;CI=1.16;7.14;
P=0.011). Severe infection and acute diarrhea were considered
not significantly different between the two groups.
Conclusion Splenectomy in thalassemia can increase the sus-
ceptibility of non-transfusion-transmitted mild infection. Further
study is needed to elaborate this finding

Author Biographies

Mururul Aisyi

Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

Alan Roland Tumbelaka

Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

Bulan Ginting Munthe

Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

Bambang Madiyono

Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia.

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