Although transfusions are life savers for such patients but at the same time lead to iron overload and expose the patients to many other complications like hypersplenism
, chronic hepatitis, human immuno-deficiency virus (HIV), venous thrombosis and osteoporosis6.
Complications were identified as cholangitis, liver failure, portal hypertension, gastroesophageal varices, ascites, hypersplenism
, hepatopulmonary syndrome, failure to thrive, and malignancy recorded at any time during the follow-up.
Thrombocytopenia secondary to hypersplenism
is a significant factor that leads to difficulties in dental management in these patients (3).
Decreased MPV value is seen in AIDS, hypersplenism
, and cytotoxic chemotherapy.
Adverse reactions leading to treatment discontinuation included one case each of hypersplenism
, abdominal pain, dyspepsia, burning sensation, and hot flash.
and massive infarction, necessitates splenectomy.
Hepatosplenomegaly is the most frequent clinical finding in NPD-B and secondary hypersplenism
, growth restriction, pulmonary involvement and mild liver failure can also be seen (2,3) The most consistent laboratory finding is an abnormal lipid profile (i.e.
 The major causes of pancytopenia include megaloblastic anemia, [3,5,8-10] aplastic anemia, [11-13] hypersplenism
, [13-17] sub-leukemic leukemia, [5,9] and infections.
, and hereditary disorders with splenomegaly.
It is believed that such cytopenias are caused by hypersplenism
but extent of cytopenias caused by hypersplenism
Patients required splenectomy because of portal hypertension or hypersplenism
and met all the following inclusion criteria: age 20-70 years, decompensated liver cirrhosis, abnormal serum albumin (ALB) and/or bilirubin and/or prothrombin time, and no viable hepatocellular carcinoma seen on a computed tomography (CT) scan.
Splenectomy should be considered in the patients with symptomatic splenomegaly not responding to immunosuppressive therapy, severe hypersplenism
, as a prophylaxis for splenic rupture and for histopathologic examination in the cases where the diagnosis is uncertain, and there is a high suspicion of malignant involvement of the spleen .