Atrophy of the spleen and WG

[ArlaMo]

Hi all! I posted an intro way back in May when I was first diagnosed, but life has been busy (darn those 6 kids! ) and although I pop in often to read, I haven't posted in a long time.

You will all be happy to know that I just got back Saturday from a week long visit to Dr. Langford and others at the Cleveland Clinic. I wish I had done it sooner!! You all were so right about that - but it was tough to get all the schedules arranged and even when I thought I had every little detail taken care of, my mom's husband ended up in the hospital while she was here watching my kids. Scrambling for alternative child care from 2000 miles away was a bit challenging!

So my question is - has anyone had experience with an atrophic spleen and WG? I had a CT chest done while at CCF and when I met with the pulmonologist, he noted that my spleen was severely atrophic as well as the pancreatic tail. I didn't get a chance to discuss it with Dr. Langford as I had already had two appointments with her earlier in the week and she was out of town the last two days I was there. In all my reading these past 10 months, I hadn't come across anything about the spleen being a particular target of WG.

Thanks!!

[drz]

Hi all! I posted an intro way back in May when I was first diagnosed, but life has been busy (darn those 6 kids! ) and although I pop in often to read, I haven't posted in a long time.

You will all be happy to know that I just got back Saturday from a week long visit to Dr. Langford and others at the Cleveland Clinic. I wish I had done it sooner!! You all were so right about that - but it was tough to get all the schedules arranged and even when I thought I had every little detail taken care of, my mom's husband ended up in the hospital while she was here watching my kids. Scrambling for alternative child care from 2000 miles away was a bit challenging!

So my question is - has anyone had experience with an atrophic spleen and WG? I had a CT chest done while at CCF and when I met with the pulmonologist, he noted that my spleen was severely atrophic as well as the pancreatic tail. I didn't get a chance to discuss it with Dr. Langford as I had already had two appointments with her earlier in the week and she was out of town the last two days I was there. In all my reading these past 10 months, I hadn't come across anything about the spleen being a particular target of WG.

Thanks!!

It happens I guess:

Asymptomatic splenic infarction in Wegener's granulomatosis

• D Papaioannides1,
• S N Nikas1,
• M Fotinou2,
• N K Akritidis3

+ Author Affiliations

• 1Department of Medicine, Arta General Hospital, Arta, Greece
• 2Department of Pathology, “Sotiria” Hospital for Chest Diseases, Athens, Greece
• 3Department of Medicine, “Hatzikosta” General Hospital, Ioannina, Greece

• Correspondence to:
  Dr D Papaioannides, PO Box 92, 47100 Arta, Greece;
  gnna@art.forthnet.gr

• Wegener's granulomatosis
• splenic infarction

Wegener's granulomatosis (WG) is a necrotising, granulomatous vasculitis that classically involves the clinicopathological triad of upper and lower respiratory tracts and the kidney. 1 Less frequently, the disease may affect other organs as well. Serious and occasionally fatal complications within the spleen occur in many autoimmune rheumatic diseases, 2 and prompt recognition of these complications is important. In a necropsy series of patients with WG, the spleen was commonly affected: 78–100% of patients had splenic lesions with a combination of necrosis, vasculitis, and granuloma formation. 3, 4 Clinically apparent splenic disease is rare, however. 1 We wish to report briefly the case of a 47 year old woman who presented with manifestations of classical WG and radiological evidence of splenic infarcts.
Case report

A 47 year old woman during the past month developed fevers to 38.6°C associated with weight loss, diffuse arthralgias, anaemia, and erythrocyte sedimentation rate of more than 100 mm/1st h. During the past three months she complained of nasal congestion …


Asymptomatic splenic infarction in Wegener's granulomatosis -- Papaioannides et al. 61 (2): 185 -- Annals of the Rheumatic Diseases

[Sangye]

I haven't heard of spleen atrophy. I wonder what Dr Langford will have to say about it.

[swhenry01]

My daughter Megan also had complications with her spleen due to Wereners. When the disease was at it's worse they did an ultrasound and catscan and determined it was not functioning. Just last week they repeated the ultrasound and found that although her Spleen had shrunk considerable - it was now somewhat functioning.

[Palmyra]

AreaMo,
Weg can go wherever it pleases, but so can our meds. The spleen is lovely, but one can live with limited function. Not so with the pancreas. My daughter suffered a rare but serious complication to immuran (azathioprine), resulting in accute pancreatitis. It was not pretty, but she did recover (required two surgeries and temporary meds/dietary changes). Did anyone test pancreatic enzymes for you? Have you had a repeat sonogram? I hope all recovers with proper treatment. Keep those docs on their toes!