Life-threatening autoimmune hemolytic anemia and idiopathic thrombocytopenic purpura: successful seletive splenic artery embolization

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matteo molica *
Fulvio Massaro
Giorgia Annechini
Erminia Baldacci
Gianna maria D'elia
Riccardo Rosati
Silvia maria trisolini
Paola Volpicelli
Robin Foà
Saveria Capria
(*) Corresponding Author:
matteo molica | matteomolica@libero.it

Abstract

Selective splenic artery embolization (SSAE) is a nonsurgical intervention characterized by the transcatheter occlusion of the splenic artery and/or its branch vessels using metallic coils or other embolic devices. It has been applied for the management of splenic trauma, hypersplenism with portal hypertension, hereditary spherocytosis, thalassemia and splenic hemangioma. We hereby describe a case of a patient affected by idiopathic thrombocytopenic purpura (ITP) and warm auto-immune hemolytic anemia (AIHA) both resistant to immunosuppressive and biological therapies, not eligible for a surgical intervention because of her critical conditions. She underwent SSAE and achieved a hematologic complete response within a few days without complications. SSAE is a minimally invasive procedure to date not considered a standard option in the management of AIHA and ITP. However, following the progressive improvement of the techniques, its indications have been extended, with a reduction in morbidity and mortality compared to splenectomy in patients with critical clinical conditions. SSAE was a lifesaving therapeutic approach for our patient and it may represent a real alternative for the treatment of resistant AIHA and ITP patients not eligible for splenectomy.


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References

1. Guan YS, Hu Y. Clinical application of partial splenic embolitazion. The Scientific World Journal 2014; 2014:1.

2. Campbell R, Marik PF. Severe autoimmune hemolytic anemia treated by paralysis, induced hypotermia and splenic embolization. Chest 2005; 127:678

3. Miyazaki M, Itoh H, Kaiho T et al. Partial splenic embolization for the treatment of chronic idiopathic thrombocytopenic purpura. American Journal of Roentgenology 1994; 163: 123

4. Barcellini W, Fattizzo B, Zaninoni A, et al. Clinical heterogeneity and predictors of outcome in primary autoimmune hemolytic anemia: a GIMEMA study of 308 patients. Blood 2014; 124:2930.

5. Spigos D, Jonasson O, Mozes M, Capek V. Partial splenic embolization in the treatment of hypersplenism. . American Journal of Roentgenology 1979; 132:777.