61:
363:
In an emergency room or hospital setting, appropriate evaluation and treatment for an asplenic febrile patient should include a complete blood count with differential, blood culture with Gram stain, arterial blood gas analysis, chest x-ray, and consideration for lumbar puncture with CSF studies. None
478:
is a rare tickborne infection. Patients should check themselves or have themselves inspected for tick bites if they are in an at-risk situation. Presentation with fever, fatigue, and haemolytic anaemia requires diagnostic confirmation by identifying the parasites within red blood cells on blood film
229:
Patients who have some form of asplenia have an increased susceptibility to these encapsulated bacterial infections mainly because they lack IgM memory B cells and their non-adherence to polysaccharide vaccines. Furthermore, there is a deficiency of other splenic cells e.g. splenic macrophages. This
422:
should be included if visiting countries of particular risk (e.g. sub-saharan Africa). The non-conjugated
Meningitis A and C vaccines usually used for this purpose give only 3 years coverage and provide less-effective long-term cover for Meningitis C than the conjugated form already mentioned.
224:
Functional asplenia can occur when patients with metabolic or haematological disorders have their splenic tissue organisation altered. This can lead to results similar to those seen in patients who have undergone a splenectomy e.g. becoming infected with encapsulated bacteria such as
294:
The risk to asplenic patients has been expressed as equivalent to an adult dying in a road traffic accident (1 to 5 percent of people without spleens would develop a severe infection per decade) (reference UK Splenectomy Trust Advice)âhence sensible precautions are advisable.
243:. This may be particularly important in poorer countries where protective measures for patients with asplenia are not available. However, it has been advised that preoperative vaccination is advisable until the remnant splenic tissue can reestablish its function.
399:, especially if not received in adolescence. Previously vaccinated adults require a single booster and non-immunised adults advised, in UK since 2006, to have two doses given two months apart. Children too young for the conjugate vaccine should receive
430:, and succumbing to its effects. Travel to malarial areas will carry greater risks and is best avoided. Travellers should take the most appropriate anti-malarial prophylaxis medication and be extra vigilant over measures to prevent mosquito bites.
393:, especially if not received in childhood. For adults who have not been previously vaccinated, two doses given two months apart was advised in the new 2006 UK vaccination guidelines (in the UK may be given as a combined Hib/MenC vaccine).
433:
The pneumococcal vaccinations may not cover some of the other strains of pneumococcal bacteria present in other countries. Likewise, their antibiotic resistance may also vary, requiring a different choice of stand-by antibiotic.
286:
The increased risk of infection is due to inability to clear opsonised bacteria from circulating blood. There is also a deficiency of T-cell independent antibodies, such as those reactive to the polysaccharide capsule of
238:
In an effort to preserve some of the spleen's protective roles, attempts are now often made to preserve a small part of the spleen when performing either surgical subtotal (partial) splenectomy, or partial splenic
1693:
1674:
1132:"Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen. Working Party of the British Committee for Standards in Haematology Clinical Haematology Task Force"
356:(for example, sore throat or cough), or at the onset of any fever. Even with a course of antibiotics and even with a history of relevant vaccination, persons without a functional spleen are at risk for
368:
guidelines state that antibiotics should be administered to a patient suspected of sepsis within 1 hour of presentation. Delay in starting antibiotics for any reason is associated with a poor outcome.
1105:
501:
which says that they do not have a working spleen. This would alert a healthcare professional to take rapid action if they become seriously ill and cannot notify them of their condition.
849:
Bader-Meunier B, Gauthier F, Archambaud F, et al. (2001). "Long-term evaluation of the beneficial effect of subtotal splenectomy for management of hereditary spherocytosis".
1603:
2102:
1806:
215:: unknown physiopathology. In a 1970 study, it was the second most common cause of abnormalities of red blood cells linked to hyposplenism, after surgical splenectomy.
1424:
550:
1181:"The prevention and treatment of infection in patients with an absent or dysfunctional spleen - British Committee for Standards in Haematology Guideline up-date"
90:
occurs when splenic tissue is present but does not work well (e.g. sickle-cell disease, polysplenia) â such patients are managed as if asplenic â while in
1489:
1228:
1065:
1345:
1633:
2095:
1799:
452:- adequate antibiotic cover is required after even minor dog or other animal bites. Asplenic patients are particularly susceptible to infection by
1097:
1229:
Davies JM, Barnes R, Milligan D, British
Committee for Standards in Haematology - Working Party of the Haematology-Oncology Task Force (2002).
1512:
2088:
1792:
1473:
1596:
1129:
1447:
376:
It is suggested that splenectomized persons receive the following vaccinations, and ideally prior to planned splenectomy surgery:
357:
264:
720:
Ferguson, Anne; Hutton, MargaretM.; Maxwell, J.D.; Murray, D. (January 1970). "Adult CÅlicac
Diseases in Hyposplenic Patients".
2183:
1887:
2255:
1959:
1441:
892:
Pratl B, Benesch M, Lackner H, et al. (2007). "Partial splenic embolization in children with hereditary spherocytosis".
390:
1230:
2326:
2030:
1428:
260:
1712:
557:
380:
172:
327:
and patients due to the complications resulting from antibiotic prophylaxis such as development of an overpopulation of
1231:"Update of guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen"
937:"Prevention of overwhelming postsplenectomy infection in thalassemia patients by partial rather than total splenectomy"
353:
349:
230:
combined with the lack of B cells can provide an environment favourable for the development of bacterial infections.
2386:
2358:
2062:
329:
584:"Splenectomy in Hodgkin's disease for splenomegaly, cytopenias and intolerance to myelosuppressive chemotherapy"
2271:
1975:
1480:
1297:"Overwhelming infection in asplenic patients: current best practice preventive measures are not being followed"
533:
518:
Online
Mendelian Inheritance in Man. OMIM entry 208530: Right atrial isomerism; RAI. Johns Hopkins University.
384:
1072:
519:
1597:"Guidelines for the prevention and treatment of infection in patients with an absent or dysfunctional spleen"
1349:
307:
Diagnosis is confirmed by abdominal ultrasonography and detection of Howell-Jolly bodies in red blood cells.
1130:
Working Party of the
British Committee for Standards in Haematology Clinical Haematology Task Force (1996).
364:
of these evaluations should delay the initiation of appropriate broad-spectrum intravenous antibiotics. The
348:
Those with asplenia are also cautioned to start a full-dose course of antibiotics at the first onset of an
187:
122:
81:
is used to describe reduced ('hypo-') splenic functioning, but not as severely affected as with asplenism.
17:
1625:
2391:
2353:
2245:
2057:
1949:
400:
396:
1055:
Kasper, D. et al (2015) Harrison's principles of internal medicine. New York, NY: McGraw-Hill
Education
1014:
Brigden, M. L. (2001). "Detection, education and management of the asplenic or hyposplenic patient".
454:
365:
1772:
269:
60:
459:
814:
Grosfeld JL, Ranochak JE (1976). "Are hemisplenectomy and/or primary splenic repair feasible?".
2250:
2080:
1954:
1784:
583:
275:
628:
Xiros, Nikolao (March 2000). "Splenectomy in patients with malignant nonâHodgkin's lymphoma".
2311:
2015:
976:
Kimber C, Spitz L, Drake D, et al. (1998). "Elective partial splenectomy in childhood".
498:
2348:
2338:
2052:
2042:
195:
191:
345:
after a surgical splenectomy, or starting at birth for congenital or functional asplenia.
8:
2331:
2210:
2035:
1914:
1697:
418:
In addition to the normal immunizations advised for the countries to be visited, Group A
206:
118:
2343:
2316:
2306:
2217:
2133:
2047:
2020:
2010:
1921:
1837:
1706:
1702:
1570:
1545:
1397:
1372:
1321:
1296:
1258:
1205:
1180:
1156:
1131:
953:
936:
917:
874:
791:
756:
697:
672:
653:
989:
827:
733:
446:- Antibiotic prophylaxis may be required before certain surgical or dental procedures.
341:
Because of the increased risk of infection, physicians administer oral antibiotics as
2170:
2143:
2138:
2128:
2111:
1874:
1847:
1842:
1832:
1815:
1575:
1437:
1402:
1326:
1263:
1210:
1161:
1023:
993:
958:
909:
905:
866:
831:
796:
778:
737:
702:
645:
641:
603:
599:
406:
140:
49:
1520:
Professional Letter: Chief
Medical Officer - Current Vaccine and Immunization Issues
921:
878:
657:
2365:
2321:
2296:
2283:
2200:
2190:
2160:
2069:
2025:
2000:
1987:
1904:
1894:
1864:
1565:
1557:
1392:
1388:
1384:
1316:
1308:
1253:
1245:
1200:
1192:
1151:
1143:
985:
948:
901:
858:
823:
786:
768:
729:
692:
684:
637:
595:
252:
54:
1758:
1602:. Wilton, Cork, Ireland: Health Service Executive, Southern Area. September 2002.
2260:
2240:
1964:
1944:
1425:"Chapter 7 : Immunisation of individuals with underlying medical conditions"
1271:
1249:
688:
537:
267:(OPSI), often fatal within a few hours. In particular, patients are at risk from
202:
158:
154:
28:
2150:
1854:
1761:
1422:
383:(not before 2 years of age). Children may first need one or more boosters of
296:
212:
1687:
1683:
1561:
2380:
2222:
1926:
1196:
1147:
782:
773:
757:"Liver-spleen axis: Intersection between immunity, infections and metabolism"
419:
280:
180:
862:
227:
Haemophilus influenzae, Streptococcus pneumoniae and
Neisseria meningitidis.
2291:
2205:
1995:
1909:
1406:
1330:
1267:
1043:
1027:
962:
913:
870:
800:
706:
649:
463:
240:
233:
1579:
1474:"Meningococcal - Children and adults with asplenia or splenic dysfunction"
1214:
1165:
997:
741:
607:
2195:
1899:
1312:
835:
488:
342:
320:
186:
After splenectomy with the goal of arresting the progression of cancers (
176:
150:
128:
171:
of interfering with splenic function, as a treatment for diseases (e.g.
2301:
2232:
2005:
1936:
1767:
474:
316:
112:
1666:
409:, every winter, to help prevent getting secondary bacterial infection.
1753:
1729:
671:
Halfdanarson, T. R.; Litzow, M. R.; Murray, J. A. (15 January 2007).
324:
32:
27:
This article is about the medical condition. For the moth genus, see
1423:
Joint
Committee on Vaccination and Immunisation (21 December 2006).
1087:- reprint from Kent and Medway NHS and Social Care Partnership Trust
426:
Those lacking a functional spleen are at higher risk of contracting
323:
protocols have been established, but are often poorly adhered to by
480:
1734:
2265:
2155:
1969:
1859:
1720:
484:
427:
2110:
1814:
1723:
1717:
1546:"The incidence of malaria after splenectomy in Papua New Guinea"
530:
2120:
1824:
1678:
848:
548:
529:
Online
Mendelian Inheritance in Man. Johns Hopkins University.
256:
183:), in which the spleen's usual activity exacerbates the disease
74:
497:- People without a working spleen can carry a card, or wear a
77:
function and is associated with some serious infection risks.
162:
117:
is rare. There are two distinct types of genetic disorders:
719:
1482:
Immunization against infectious disease - 'The Green Book'
299:
can be seen in individuals without a functioning spleen.
670:
234:
Partial splenectomy and preservation of splenic function
935:
Sheikha AK, Salih ZT, Kasnazan KH, et al. (2007).
531:
OMIM entry 271400: Asplenia, isolated congenital; ICAS.
1510:
1427:. In Editors Salisbury D, Ramsay M, Noakes K (eds.).
1656:
1623:
934:
201:
Due to underlying diseases that destroy the spleen (
1591:
1589:
891:
387:
if they did not complete the full childhood series.
315:To minimise the risks associated with splenectomy,
1513:"Meningococcal immunisation for asplenic patients"
1371:Huebner, Mitchell; Kristin, Kristin (July 2015).
2378:
1586:
975:
813:
1071:. Splenectomy Trust. March 2002. Archived from
1370:
1039:
1037:
1009:
1007:
673:"Hematologic manifestations of celiac disease"
2096:
1800:
1219:- published as a response by original authors
1543:
1430:Immunisation Against Infectious Disease 2006
1418:
1416:
1377:Baylor University Medical Center Proceedings
1222:
928:
885:
842:
283:. The risk is elevated as much as 350âfold.
1537:
1034:
1004:
969:
2103:
2089:
1807:
1793:
1294:
1125:
1123:
581:
59:
1569:
1413:
1396:
1320:
1257:
1204:
1178:
1155:
952:
807:
790:
772:
754:
696:
523:
512:
336:
549:Leukemia & Lymphoma Society (2017).
458:and should receive a five-day course of
1288:
1172:
1120:
1013:
358:Overwhelming post-splenectomy infection
265:overwhelming post splenectomy infection
14:
2379:
2184:Asplenia with cardiovascular anomalies
1888:Asplenia with cardiovascular anomalies
1544:Boone KE, Watters DA (November 1995).
1346:"Asplenia Poses Management Challenges"
437:
219:
2256:Intranodal palisaded myofibroblastoma
2084:
1960:Intranodal palisaded myofibroblastoma
1788:
1344:Wick, Jeannette (September 1, 2006).
1179:Davies JM; et al. (2001-06-02).
627:
391:Haemophilus influenzae type b vaccine
1343:
582:Lowenbraun, Stanley (January 1971).
491:) is usually an effective treatment.
466:in patients allergic to penicillin).
401:meningococcal polysaccharide vaccine
261:polysaccharide encapsulated bacteria
381:Pneumococcal polysaccharide vaccine
173:idiopathic thrombocytopenic purpura
24:
1636:from the original on 2 August 2019
413:
25:
2403:
1652:
1492:from the original on 26 July 2020
761:World Journal of Gastroenterology
354:lower respiratory tract infection
2359:Postmastectomy lymphangiosarcoma
2327:Lymphedemaâdistichiasis syndrome
2063:Postmastectomy lymphangiosarcoma
2031:Lymphedemaâdistichiasis syndrome
1488:. 24 August 2009 . p. 244.
1436:. Edinburgh: Stationery Office.
1348:. Pharmacy Times. Archived from
1108:from the original on 9 July 2021
906:10.1111/j.1600-0609.2007.00979.x
642:10.1034/j.1600-0609.2000.90079.x
588:The American Journal of Medicine
73:refers to the absence of normal
1617:
1606:from the original on 2012-03-04
1504:
1466:
1364:
1337:
1090:
1058:
1049:
894:European Journal of Haematology
630:European Journal of Haematology
397:Meningococcal conjugate vaccine
371:
97:, the spleen itself is absent.
2272:Template:Respiratory pathology
1976:Template:Respiratory pathology
1511:Chief Medical Officer (2001).
1389:10.1080/08998280.2015.11929267
748:
713:
664:
621:
575:
551:"Chronic Lymphocytic Leukemia"
542:
444:Surgical and dental procedures
385:pneumococcal conjugate vaccine
13:
1:
1301:Journal of Clinical Pathology
990:10.1016/S0022-3468(98)90651-0
828:10.1016/S0022-3468(76)80198-4
734:10.1016/S0140-6736(70)90405-8
505:
310:
105:
1462:see pages 50-1 and table 7.1
1250:10.7861/clinmedicine.2-5-440
978:Journal of Pediatric Surgery
755:Tarantino, Giovanni (2013).
689:10.1182/blood-2006-07-031104
600:10.1016/0002-9343(71)90204-X
556:. p. 15. Archived from
302:
188:Chronic lymphocytic leukemia
145:occurs for several reasons:
123:isolated congenital asplenia
7:
2354:Postinflammatory lymphedema
2246:Generalized lymphadenopathy
2114:: organ and vessel diseases
2058:Postinflammatory lymphedema
1950:Generalized lymphadenopathy
1818:: organ and vessel diseases
1066:"Splenectomy and Infection"
941:Canadian Journal of Surgery
499:special bracelet or necklet
167:After splenectomy with the
134:
10:
2408:
1624:HSC Public Health Agency.
31:. For the fern genus, see
26:
2282:
2231:
2169:
2119:
1986:
1935:
1873:
1823:
1744:
1660:
1626:"Splenectomy wallet card"
1562:10.1136/bmj.311.7015.1273
1526:. Department of Health: 4
1016:American Family Physician
455:Capnocytophaga canimorsus
366:Surviving Sepsis Campaign
333:in the intestinal tract.
297:Increased platelet counts
255:, increasing the risk of
194:(starting in the 1970s),
100:
48:
43:
1630:HSC Public Health Agency
1197:10.1136/bmj.312.7028.430
1148:10.1136/bmj.312.7028.430
774:10.3748/wjg.v19.i23.3534
289:Streptococcus pneumoniae
270:Streptococcus pneumoniae
246:
2387:Immune system disorders
863:10.1182/blood.V97.2.399
460:amoxicillin/clavulanate
1098:"Asplenia/Hyposplenia"
337:Antibiotic prophylaxis
276:Haemophilus influenzae
251:Asplenia is a form of
2312:Congenital lymphedema
2016:Congenital lymphedema
1102:Unbound Medicine, Inc
330:Clostridium difficile
2349:Factitial lymphedema
2339:Secondary lymphedema
2053:Factitial lymphedema
2043:Secondary lymphedema
1373:"Asplenia and fever"
1313:10.1136/jcp.54.3.214
263:, and can result in
196:non-Hodgkin lymphoma
2251:Castleman's disease
1955:Castleman's disease
1295:Waghorn DJ (2001).
1022:(3): 499â506, 508.
438:Additional measures
220:Functional asplenia
207:sickle-cell disease
119:heterotaxy syndrome
2392:Diseases of spleen
2344:Bullous lymphedema
2317:Lymphedema praecox
2307:Primary lymphedema
2218:Splenic infarction
2048:Bullous lymphedema
2021:Lymphedema praecox
2011:Primary lymphedema
1922:Splenic infarction
1745:External resources
1450:on 2 December 2008
536:2022-01-22 at the
2374:
2373:
2284:Lymphatic vessels
2144:DiGeorge syndrome
2112:Lymphatic disease
2078:
2077:
1988:Lymphatic vessels
1848:DiGeorge syndrome
1816:Lymphatic disease
1782:
1781:
1443:978-0-11-322528-6
1352:on April 12, 2013
1238:Clinical Medicine
728:(7639): 163â164.
487:(with or without
407:Influenza vaccine
192:Hodgkin's disease
68:
67:
38:Medical condition
16:(Redirected from
2399:
2366:Waldmann disease
2332:Milroy's disease
2322:Lymphedema tarda
2297:Lymphangiectasia
2211:Banti's syndrome
2201:Wandering spleen
2191:Accessory spleen
2161:Thymic carcinoma
2105:
2098:
2091:
2082:
2081:
2070:Waldmann disease
2036:Milroy's disease
2026:Lymphedema tarda
2001:Lymphangiectasia
1915:Banti's syndrome
1905:Wandering spleen
1895:Accessory spleen
1865:Thymic carcinoma
1809:
1802:
1795:
1786:
1785:
1658:
1657:
1646:
1645:
1643:
1641:
1621:
1615:
1614:
1612:
1611:
1601:
1593:
1584:
1583:
1573:
1541:
1535:
1534:
1532:
1531:
1517:
1508:
1502:
1501:
1499:
1497:
1487:
1478:
1470:
1464:
1459:
1457:
1455:
1446:. Archived from
1435:
1420:
1411:
1410:
1400:
1368:
1362:
1361:
1359:
1357:
1341:
1335:
1334:
1324:
1292:
1286:
1285:
1283:
1282:
1276:
1270:. Archived from
1261:
1235:
1226:
1220:
1218:
1208:
1176:
1170:
1169:
1159:
1127:
1118:
1117:
1115:
1113:
1094:
1088:
1086:
1084:
1083:
1077:
1070:
1062:
1056:
1053:
1047:
1041:
1032:
1031:
1011:
1002:
1001:
973:
967:
966:
956:
932:
926:
925:
889:
883:
882:
846:
840:
839:
816:J. Pediatr. Surg
811:
805:
804:
794:
776:
752:
746:
745:
717:
711:
710:
700:
668:
662:
661:
625:
619:
618:
616:
614:
579:
573:
572:
570:
568:
562:
555:
546:
540:
527:
521:
516:
479:and by specific
253:immunodeficiency
64:
63:
55:Medical genetics
41:
40:
21:
2407:
2406:
2402:
2401:
2400:
2398:
2397:
2396:
2377:
2376:
2375:
2370:
2278:
2261:Kikuchi disease
2241:Lymphadenopathy
2227:
2165:
2115:
2109:
2079:
2074:
1982:
1965:Kikuchi disease
1945:Lymphadenopathy
1931:
1869:
1819:
1813:
1783:
1778:
1777:
1740:
1739:
1669:
1655:
1650:
1649:
1639:
1637:
1622:
1618:
1609:
1607:
1599:
1595:
1594:
1587:
1542:
1538:
1529:
1527:
1515:
1509:
1505:
1495:
1493:
1485:
1476:
1472:
1471:
1467:
1453:
1451:
1444:
1433:
1421:
1414:
1369:
1365:
1355:
1353:
1342:
1338:
1293:
1289:
1280:
1278:
1274:
1233:
1227:
1223:
1191:(7028): 430â4.
1177:
1173:
1142:(7028): 430â4.
1128:
1121:
1111:
1109:
1096:
1095:
1091:
1081:
1079:
1075:
1068:
1064:
1063:
1059:
1054:
1050:
1042:
1035:
1012:
1005:
974:
970:
933:
929:
890:
886:
847:
843:
812:
808:
767:(23): 3534â42.
753:
749:
718:
714:
669:
665:
626:
622:
612:
610:
580:
576:
566:
564:
563:on 18 June 2018
560:
553:
547:
543:
538:Wayback Machine
528:
524:
517:
513:
508:
440:
416:
414:Travel measures
403:in the interim.
374:
339:
313:
305:
249:
236:
222:
203:autosplenectomy
155:splenic rupture
137:
108:
103:
58:
39:
36:
29:Asplenia (moth)
23:
22:
15:
12:
11:
5:
2405:
2395:
2394:
2389:
2372:
2371:
2369:
2368:
2363:
2362:
2361:
2356:
2351:
2346:
2336:
2335:
2334:
2329:
2324:
2319:
2314:
2304:
2299:
2294:
2288:
2286:
2280:
2279:
2277:
2276:
2275:
2274:
2263:
2258:
2253:
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2237:
2235:
2229:
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2226:
2225:
2220:
2215:
2214:
2213:
2203:
2198:
2193:
2188:
2187:
2186:
2175:
2173:
2167:
2166:
2164:
2163:
2158:
2153:
2151:Ectopic thymus
2148:
2147:
2146:
2136:
2131:
2125:
2123:
2117:
2116:
2108:
2107:
2100:
2093:
2085:
2076:
2075:
2073:
2072:
2067:
2066:
2065:
2060:
2055:
2050:
2040:
2039:
2038:
2033:
2028:
2023:
2018:
2008:
2003:
1998:
1992:
1990:
1984:
1983:
1981:
1980:
1979:
1978:
1967:
1962:
1957:
1952:
1947:
1941:
1939:
1933:
1932:
1930:
1929:
1924:
1919:
1918:
1917:
1907:
1902:
1897:
1892:
1891:
1890:
1879:
1877:
1871:
1870:
1868:
1867:
1862:
1857:
1855:Ectopic thymus
1852:
1851:
1850:
1840:
1835:
1829:
1827:
1821:
1820:
1812:
1811:
1804:
1797:
1789:
1780:
1779:
1776:
1775:
1764:
1749:
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1746:
1742:
1741:
1738:
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1709:
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1670:
1665:
1664:
1662:
1661:Classification
1654:
1653:External links
1651:
1648:
1647:
1616:
1585:
1556:(7015): 1273.
1536:
1503:
1465:
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1287:
1221:
1171:
1119:
1089:
1057:
1048:
1033:
1003:
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857:(2): 399â403.
841:
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663:
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338:
335:
312:
309:
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301:
248:
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235:
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221:
218:
217:
216:
213:Celiac disease
210:
199:
184:
165:
161:or because of
136:
133:
132:
131:
126:
107:
104:
102:
99:
66:
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52:
46:
45:
37:
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2239:
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2234:
2230:
2224:
2223:Splenic tumor
2221:
2219:
2216:
2212:
2209:
2208:
2207:
2204:
2202:
2199:
2197:
2194:
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2159:
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2101:
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2064:
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2056:
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2044:
2041:
2037:
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2032:
2029:
2027:
2024:
2022:
2019:
2017:
2014:
2013:
2012:
2009:
2007:
2004:
2002:
1999:
1997:
1994:
1993:
1991:
1989:
1985:
1977:
1973:
1972:
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1968:
1966:
1963:
1961:
1958:
1956:
1953:
1951:
1948:
1946:
1943:
1942:
1940:
1938:
1934:
1928:
1927:Splenic tumor
1925:
1923:
1920:
1916:
1913:
1912:
1911:
1908:
1906:
1903:
1901:
1898:
1896:
1893:
1889:
1886:
1885:
1884:
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1866:
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1858:
1856:
1853:
1849:
1846:
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1836:
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1810:
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1774:
1770:
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1577:
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1563:
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1514:
1507:
1491:
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1408:
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1399:
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1386:
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1378:
1374:
1367:
1351:
1347:
1340:
1332:
1328:
1323:
1318:
1314:
1310:
1306:
1302:
1298:
1291:
1277:on 2009-11-05
1273:
1269:
1265:
1260:
1255:
1251:
1247:
1243:
1239:
1232:
1225:
1216:
1212:
1207:
1202:
1198:
1194:
1190:
1186:
1182:
1175:
1167:
1163:
1158:
1153:
1149:
1145:
1141:
1137:
1133:
1126:
1124:
1107:
1103:
1099:
1093:
1078:on 2007-09-28
1074:
1067:
1061:
1052:
1045:
1040:
1038:
1029:
1025:
1021:
1017:
1010:
1008:
999:
995:
991:
987:
983:
979:
972:
964:
960:
955:
950:
946:
942:
938:
931:
923:
919:
915:
911:
907:
903:
899:
895:
888:
880:
876:
872:
868:
864:
860:
856:
852:
845:
837:
833:
829:
825:
822:(3): 419â24.
821:
817:
810:
802:
798:
793:
788:
784:
780:
775:
770:
766:
762:
758:
751:
743:
739:
735:
731:
727:
723:
716:
708:
704:
699:
694:
690:
686:
682:
678:
674:
667:
659:
655:
651:
647:
643:
639:
636:(3): 145â50.
635:
631:
624:
609:
605:
601:
597:
593:
589:
585:
578:
559:
552:
545:
539:
535:
532:
526:
520:
515:
511:
500:
496:
495:Alert warning
493:
490:
486:
482:
477:
476:
471:
468:
465:
461:
457:
456:
451:
448:
445:
442:
441:
435:
431:
429:
424:
421:
420:meningococcus
408:
405:
402:
398:
395:
392:
389:
386:
382:
379:
378:
377:
369:
367:
361:
359:
355:
351:
346:
344:
334:
332:
331:
326:
322:
318:
308:
300:
298:
292:
290:
284:
282:
281:meningococcus
278:
277:
272:
271:
266:
262:
258:
254:
244:
242:
231:
228:
214:
211:
208:
204:
200:
197:
193:
189:
185:
182:
181:spherocytosis
178:
174:
170:
166:
164:
160:
156:
152:
148:
147:
146:
144:
142:
130:
127:
124:
120:
116:
114:
110:
109:
98:
96:
94:
89:
87:
82:
80:
76:
72:
62:
56:
53:
51:
47:
42:
34:
30:
19:
2292:Lymphangitis
2206:Splenomegaly
2178:
1996:Lymphangitis
1910:Splenomegaly
1882:
1766:
1752:
1728:
1711:
1692:
1673:
1638:. Retrieved
1629:
1619:
1608:. Retrieved
1553:
1549:
1539:
1528:. Retrieved
1523:
1519:
1506:
1494:. Retrieved
1481:
1468:
1461:
1452:. Retrieved
1448:the original
1429:
1383:(3): 340â1.
1380:
1376:
1366:
1354:. Retrieved
1350:the original
1339:
1307:(3): 214â8.
1304:
1300:
1290:
1279:. Retrieved
1272:the original
1244:(5): 440â3.
1241:
1237:
1224:
1188:
1184:
1174:
1139:
1135:
1110:. Retrieved
1101:
1092:
1080:. Retrieved
1073:the original
1060:
1051:
1044:AAP Red Book
1019:
1015:
984:(6): 826â9.
981:
977:
971:
947:(5): 382â6.
944:
940:
930:
900:(1): 76â80.
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893:
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850:
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680:
676:
666:
633:
629:
623:
611:. Retrieved
594:(1): 49â55.
591:
587:
577:
565:. Retrieved
558:the original
544:
525:
514:
494:
473:
469:
464:erythromycin
453:
450:Animal bites
449:
443:
432:
425:
417:
375:
372:Vaccinations
362:
347:
340:
328:
314:
306:
293:
288:
285:
274:
268:
250:
241:embolization
237:
226:
223:
168:
139:
138:
111:
92:
91:
85:
84:
83:
79:Hyposplenism
78:
70:
69:
18:Hyposplenism
2196:Polysplenia
2134:Hyperplasia
1900:Polysplenia
1838:Hyperplasia
1632:. Belfast.
489:clindamycin
343:prophylaxis
321:vaccination
177:thalassemia
151:splenectomy
129:polysplenia
2381:Categories
2302:Lymphedema
2233:Lymph node
2139:Hypoplasia
2006:Lymphedema
1937:Lymph node
1843:Hypoplasia
1768:Patient UK
1610:2009-10-09
1530:2009-11-07
1496:7 November
1281:2010-02-01
1082:2006-12-12
722:The Lancet
506:References
475:Babesiosis
470:Tick bites
325:physicians
317:antibiotic
311:Management
149:Following
113:Congenital
106:Congenital
86:Functional
1754:eMedicine
1735:707147002
1730:SNOMED CT
783:1007-9327
303:Diagnosis
50:Specialty
33:Asplenium
2179:Asplenia
1883:Asplenia
1773:Asplenia
1762:radio/58
1640:1 August
1634:Archived
1604:Archived
1490:Archived
1407:26130882
1331:11253134
1268:12448592
1106:Archived
1028:11272299
963:18031639
922:41343243
914:18028435
879:22741973
871:11154215
801:23801854
707:16973955
658:20986297
650:10997879
534:Archived
481:serology
205:), e.g.
143:asplenia
141:Acquired
135:Acquired
115:asplenia
95:asplenia
93:anatomic
88:asplenia
71:Asplenia
44:Asplenia
2266:Tonsils
2156:Thymoma
2129:Abscess
1970:Tonsils
1860:Thymoma
1833:Abscess
1759:ped/150
1721:%271400
1580:7496237
1571:2551185
1454:22 July
1398:4462215
1356:18 June
1322:1731383
1259:4953085
1215:8601117
1206:2350106
1166:8601117
1157:2350106
998:9660206
954:2386178
792:3691032
742:4189238
698:1785098
613:18 June
608:5539576
567:18 June
485:Quinine
428:malaria
153:due to
2171:Spleen
2121:Thymus
1875:Spleen
1825:Thymus
1724:208540
1718:208530
1707:759.01
1703:289.59
1578:
1568:
1440:
1405:
1395:
1329:
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1266:
1256:
1213:
1203:
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781:
740:
705:
695:
656:
648:
606:
279:, and
257:sepsis
159:trauma
101:Causes
75:spleen
57:
1688:Q89.0
1684:D73.0
1600:(PDF)
1516:(PDF)
1486:(PDF)
1477:(PDF)
1434:(PDF)
1275:(PDF)
1234:(PDF)
1076:(PDF)
1069:(PDF)
1046:2006.
918:S2CID
875:S2CID
851:Blood
677:Blood
654:S2CID
561:(PDF)
554:(PDF)
350:upper
259:from
247:Risks
163:tumor
157:from
2270:see
1974:see
1713:OMIM
1698:9-CM
1642:2019
1576:PMID
1498:2009
1456:2007
1438:ISBN
1403:PMID
1358:2018
1327:PMID
1264:PMID
1211:PMID
1162:PMID
1114:2021
1024:PMID
994:PMID
959:PMID
910:PMID
867:PMID
832:PMID
797:PMID
779:ISSN
738:PMID
703:PMID
646:PMID
615:2018
604:PMID
569:2018
319:and
169:goal
121:and
1694:ICD
1675:ICD
1566:PMC
1558:doi
1554:311
1550:BMJ
1393:PMC
1385:doi
1317:PMC
1309:doi
1254:PMC
1246:doi
1201:PMC
1193:doi
1189:312
1185:BMJ
1152:PMC
1144:doi
1140:312
1136:BMJ
986:doi
949:PMC
902:doi
859:doi
824:doi
787:PMC
769:doi
730:doi
726:295
693:PMC
685:doi
681:109
638:doi
596:doi
352:or
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
