HYPERSPLENISM: TWO CASES WITH LEG ULCERS TREATED BY SPLENECTOMY

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Abstract
Two cases are reported which are characterized by rheumatoid arthritis, splenomegaly, chronic leg ulcer, leukopenia, neutropenia, anemia and elevated basal metabolism rate. Following splenectomy there was in each case a significant gain in wt. and improvement in general condition. The anemia was corrected and the white blood cell picture temporarily became normal, gradually reverting to the leukopenic-neutropenic state. There was a diminution in the basal metabolism rate. There was a marked improvement in the leg ulcers with final complete epithelialization after skin grafting. This was impossible before splenectomy. In one case the leg ulcer recurred as well as the previous abnormalities in the blood cell picture, and the patient expired ten months after splenectomy. The 2d patient remained well 22 months after splenectomy, but leukopenia and granulo-cytopenia have returned, followed by a normal blood picture.