Improving cytopenia with splenic artery embolization in a patient with paroxysmal nocturnal hemoglobinuria on eculizumab | Aplastic Anemia and MDS International Foundation

Improving cytopenia with splenic artery embolization in a patient with paroxysmal nocturnal hemoglobinuria on eculizumab

Journal Title: 
Int J Hematol
Author(s): 
Krishnan SK, Hill A, Hillmen P, Arnold LM, Brooksbank GL, Wood A, Scarsbrook A, Davies MH, Kelly RJ
Primary Author: 
Krishnan SK
Original Publication Date: 
Sunday, December 1, 2013

Paroxysmal nocturnal hemoglobinuria is a rare acquired stem cell disorder characterized by intravascular hemolysis, aplasia and an increased risk of thrombosis. We describe a patient under treatment with the anti-complement antibody eculizumab who developed pancytopenia, requiring blood transfusions, due to massive splenomegaly. The patient underwent two separate splenic embolizations, which reduced the size of the spleen and improved his blood count to the point that blood transfusions were no longer necessary. Splenic embolization was chosen over splenectomy due to the potential postoperative complications of splenectomy, especially that of thrombosis.