Management of hypersplenism in hemolytic anemias

The clinical course of patients with chronic hemolytic anemia can be complicated by the development of splenomegaly and consequent hypersplenism. This may warrant management by medical or surgical methods. Furthermore, in some patients, splenic manipulation may be warranted in the absence of hypersplenism, spleen being the primary site of red cell destruction. Wherever possible, splenectomy is avoided or deferred in view of the life-long risks of infection and thrombosis associated with this procedure. Optimal management in hemolytic anemia, therefore, incorporates prevention of hypersplenism as one of the key treatment goals.