Spherocytosis
(Congenital Spherocytic Anemia; Hereditary Spherocytosis)
Pronounced: sf-er-oh-sigh-TO-sis
Definition
Spherocytosis is a condition that causes an abnormality in the red blood cell membrane. While healthy blood cells are shaped like flattened, indented disks, these abnormal membranes lead to sphere-shaped red blood cells, and the premature breakdown of those cells.
Red blood cells suffering from spherocytosis are smaller, rounder in shape, and more fragile than healthy red blood cells. The rounded shape causes the red blood cells to be caught in the spleen, where they break down.
Spherocytosis occurs in all races, but is most common in people of northern European descent.
Spherocytosis cases may be very mild, with minor symptoms, or very severe with symptoms that quickly surface. These symptoms may occur after certain types of infections. Severe cases may be diagnosed in childhood, while those with mild symptoms may not be diagnosed until into adulthood.
With treatment, symptoms can be controlled.
Healthy Red Blood Cells
Risk Factors
A risk factor is something that increases your chance of getting a disease or condition.
The following factors increase your chance of developing spherocytosis:
- Having a family member with spherocytosis
Symptoms
Symptoms include:
- Jaundice
- Pallor
- Shortness of breath
- Fatigue
- Weakness
- In children, irritability and moodiness
- Hemolytic anemia
- Gallstones
Diagnosis
Your doctor will ask about your symptoms and medical history, and perform a physical exam.
Tests may include the following:
- Examination of the spleen
- Blood tests
- Liver function tests
- Osmotic and incubated fragility tests to diagnose hereditary spherocytosis
- Coombs' Test—an antiglobulin test to examine red blood cell antibodies
Treatment
Talk with your doctor about the best treatment plan for you. Treatment options include:
Folic Acid Supplementation
Folic acid 1 mg daily and consideration for blood transfusions are recommended during periods of severe anemia .
Surgery
Surgical removal of the spleen can cure the anemia. The abnormal shape of blood cells remain, but the blood cells are no longer destroyed in the spleen.
Currently, meningococcal , Haemophilus , and pneumococcal vaccines are administered several weeks before splenectomy. Lifetime penicillin prophylaxis is recommended after surgery to prevent dangerous infections. The surgery is not recommended for children under the age of five. There is a lifetime risk of serious and potentially life threatening infections.
RESOURCES:
Cincinnati Children's Hospital Medical Center
http://www.cincinnatichildrens.org/
University of Virginia Health System
http://www.med-ed.virginia.edu/
CANADIAN RESOURCES:
About Kids Health
http://www.aboutkidshealth.ca
Alberta Children's Services
http://www.child.alberta.ca/home/
References:
Congenital spherocytic anemia. Medline Plus Medical Encyclopedia. US National Library of Medicine website. Available at: http://www.nlm.nih.gov/medlineplus/ency/article/000530.htm . Accessed June 27, 2007.
Delaunay J. The molecular basis of hereditary red blood cell membrane disorders. Blood Rev . 2007;21:1-20.
Hereditary spherocytosis. Texas Children's Cancer Center and Hematology Service. Baylor College of Medicine website. Available at:
http://www.bcm.edu/pediatrics/documents/4112.pdf
.
Accessed June 27, 2007.
Treatment of anemia at Mayo Clinic. Mayo Clinic website. Available at: http://www.mayoclinic.org/anemia/index.html . Accessed June 27, 2007.
Last reviewed November 2008 by Michael J. Fucci, DO
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
Copyright © 2007 EBSCO Publishing All rights reserved.