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THE SPLEEN

  • The white pulp (lymphoid tissue) functions in antigen processing and antibody production.

  • The red pulp (monocyte-macrophage system) serves as a filter, retaining defective or effete blood cells and foreign particles.

HYPERSPLENISM (INCREASED SPLENIC FUNCTION)

  • Hypersplenism is considered "appropriate" if it is an exaggeration of normal function, as in hereditary spherocytosis or idiopathic thrombocytopenic purpura, or "inappropriate" if the hyperfunction is a result of vascular congestion or infiltrative disease.

  • Usually associated with splenomegaly.

  • Causes cytopenias with associated compensatory bone marrow hyperplasia.

  • Usually corrected by splenectomy, if indicated.

  • Table 28–1 lists the causes of hypersplenism; Table 28–2 lists the causes of massive splenomegaly.

TABLE 28–1CLASSIFICATION AND THE MOST COMMON CAUSES OF SPLENOMEGALY AND HYPERSPLENISM
TABLE 28–2CAUSES OF MASSIVE SPLENOMEGALY

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