Autosplenectomy

Consequences

Absence of effective splenic function or absence of the whole spleen (asplenia) is associated with increased risks of overwhelming post-splenectomy infection, especially from polysaccharide encapsulated bacteria and organisms that invade erythrocytes. People without a spleen have a weakened immune system, although other immune organs compensate for the missing spleen. Vaccination against encapsulated bacteria and prophylactic antibiotics can be used to counteract lowered immunity in asplenic patients. Specifically, people without a spleen are recommended to be vaccinated against pneumonia, influenza, Haemophilus influenzae type b and meningococci.

Testing for autosplenectomy

One of the spleen's main tasks is to filter the blood and remove and recycle damaged or old red blood cells. Splenic function can be measured by filtering capabilities, as indicated by number of Howell-Jolly bodies or pitted erythrocytes in the blood. Both of these tests examine whether or not the spleen is functioning normally by testing splenic outputs.

Howell-Jolly bodies

Howell–Jolly bodies are found on red blood cells and contain chromatin remnants from basophilic cells. Under normal conditions, these nuclear remnants are removed from the blood by the spleen's filtering capabilities. Howell-Jolly bodies can be identified and quantified using a blood smear or by flow cytometry. A high number of Howell-Jolly bodies is indicative of splenic hypofunction and potentially autosplenectomy.

Pitted erythrocytes

Erythrocytes with membrane pits can be indicative of splenic dysfunction as a healthy spleen clears blood of pitted erythrocytes. Pitted erythrocytes can be counted using Normarsky optics. Humans with healthy spleens have less than two percent of their red blood cells contain pits. In comparison, a person with asplenia may have up to 50% of their red blood cells contain pits.