Outcomes of splenectomy in patients with common variable immunodeficiency (CVID): a survey of 45 patients (vol 172, pg 63, 2013)

被引：0

作者：

Wong, G. K. ^{[1
]}

Goldacker, S. ^{[2
]}

Winterhalter, C. ^{[2
]}

Grimbacher, B. ^{[3
]}

Chapel, H. ^{[4
]}

Lucas, M. ^{[4
]}

Alecsandru, D. ^{[3
]}

McEwen, D. ^{[4
]}

Quinti, I. ^{[5
]}

Martini, H. ^{[5
]}

Milito, C. ^{[5
]}

Schmidt, R. E. ^{[6
]}

Ernst, D. ^{[6
]}

Espanol, T. ^{[7
]}

Vidaller, A. ^{[8
]}

Carbone, J. ^{[9
]}

Fernandez-Cruz, E. ^{[9
]}

Lougaris, V. ^{[10
]}

Plebani, A. ^{[10
]}

Kutukculer, N. ^{[11
]}

Gonzalez-Granado, L. I. ^{[12
]}

Contreras, R. ^{[12
]}

Kiani-Alikhan, S. ^{[13
,14
]}

Ibrahim, M. A. A. ^{[13
,14
]}

Litzman, J. ^{[15
]}

Jones, A. ^{[16
]}

Gaspar, H. B. ^{[16
]}

Hammarstrom, L. ^{[17
,18
]}

Baumann, U. ^{[19
]}

Warnatz, K.

Huissoon, A. P.

机构：

[1] Birmingham Heartlands Hosp, West Midlands Primary Immunodeficiency Ctr, Birmingham, W Midlands, England

[2] Univ Med Ctr, Ctr Chron Immunodeficiency, Freiburg, Germany

[3] Royal Free Hosp, Ctr Immunodeficiency, London NW3 2QG, England

[4] Univ Oxford, Nuffield Dept Med, Primary Immunodeficiency Unit, Oxford OX1 2JD, England

[5] Univ Roma La Sapienza, Dept Mol Med, Rome, Italy

[6] Hannover Med Sch, Dept Clin Immunol & Rheumatol, Hannover, Germany

[7] Hosp Valle De Hebron, Immunol Unit, Barcelona, Spain

[8] Bellvitge Hosp, Barcelona, Spain

[9] Univ Complutense Madrid, Div Clin Immunol, Hosp Gen Univ Gregorio Maranon, Dept Microbiol 1, E-28040 Madrid, Spain

[10] Univ Brescia, Pediat Clin, I-25121 Brescia, Italy

[11] Ege Univ, Sch Med, Dept Pediat Immunol, Izmir, Turkey

[12] Pediat Infect Dis & Immunodeficiencies Unit, Madrid, Spain

[13] Kings Coll London, London, England

[14] Kings Coll Hosp London, Kings Hlth Partners, Dept Clin Immunol & Allergy, London, England

[15] Masaryk Univ, Fac Med, St Annes Univ Hosp, Dept Clin Immunol & Allergol, Brno, Czech Republic

[16] Great Ormond St Hosp Sick Children, Dept Immunol, London WC1N 3JH, England

[17] Karolinska Inst, Dept Lab Med, Div Clin Immunol, Stockholm, Sweden

[18] Karolinska Univ, Huddinge Hosp, Stockholm, Sweden

[19] Hannover Med Sch, Hannover, Germany

来源：

CLINICAL AND EXPERIMENTAL IMMUNOLOGY | 2013年 / 173卷 / 01期

关键词：

Autoimmune cytopenia; Common variable immunodeficiency; Splenectomy; Splenomegaly;

D O I：

10.1111/cei.12130

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Splenectomy has been used in patients with common variable immunodeficiency disorders (CVID), mainly in the context of refractory autoimmune cytopenia and suspected lymphoma, but there are understandable concerns about the potential of compounding an existing immunodeficiency. With increasing use of rituximab as an alternative treatment for refractory autoimmune cytopenia, the role of splenectomy in CVID needs to be re-examined. This retrospective study provides the largest cohesive data set to date describing the outcome of splenectomy in 45 CVID patients in the past 40 years. Splenectomy proved to be an effective long-term treatment in 75% of CVID patients with autoimmune cytopenia, even in some cases when rituximab had failed. Splenectomy does not worsen mortality in CVID and adequate immunoglobulin replacement therapy appears to play a protective role in overwhelming post-splenectomy infections. Future trials comparing the effectiveness and safety of rituximab and splenectomy are needed to provide clearer guidance on the second-line management of autoimmune cytopenia in CVID.

引用

页码：161 / 161

页数：1