Transient functional asplenism in sickle cell-C disease

During a painful crisis, the spleen of a patient with sickle cell-C disease failed to visualize with 99^m Tc-sulfur colloid although it was significantly enlarged by palpation. At that time, the peripheral blood smear showed numerous sickle cells, normoblasts and erythrocytes containing Howell-Jolly bodies. After therapy with hypotonic saline solution and with clinical improvement, the enlarged spleen was completely visualized on repeat scanning. The normoblasts and erythrocytes containing Howell-Jolly bodies also decreased in number. This case of transient asplenism is similar to the cases previously reported only in children with homozygous sickle cell disease. The significance of this phenomenon with respect to increased susceptibility to infection is discussed.