Successful Treatment of Hypersplenism in Wilson's Disease by Partial Splenic Embolization

ABSTRACT

Aim: Hypersplenism can occur in patients with Wilson's disease (WD). Surgical splenectomy is a conventional treatment for this condition; however, emotional and neurological deterioration may follow splenectomy. In recent years, partial splenic embolization (PSE) has been increasingly performed as a nonsurgical alternative treatment for hypersplenism. The aim of this study was to evaluate the effectiveness and safety of PSE compared with splenectomy in the treatment of hypersplenism in WD patients. Methods: Fifty WD patients with hypersplenism were randomly divided into two groups (group A and group B), each including 25 patients. Patients in groups A and B were treated with PSE and splenectomy, respectively. Data were collected on the clinical efficacy of each procedure, adverse reactions, hematologic and blood chemistry test results, and abdominal computed tomography (CT) scan findings (group A only). Results: Marked improvements in the platelet and leukocyte counts after PSE and splenectomy were observed in all patients. PSE was associated with improved liver function without severe complications, and no significant changes in emotional and neurological symptoms were observed. In contrast, seven WD patients suffered neurological deterioration after splenectomy. Conclusions: Hypersplenism in WD patients was successfully treated by PSE, which appears to be a safe and effective alternative treatment for WD-induced hypersplenism.

Keywords::

• partial splenic embolization
• splenectomy
• hypersplenism
• Wilson's disease
• neurological deterioration
• sodium 2,3-dimercapto-1-propane sulfonate (DMPS)

Acknowledgments

The authors thank all the participants in this program for their help and cooperation, as well as their colleagues in the working groups. The research was supported by the National Natural Science Foundation of China (grant number: 81373599).

Declaration of Interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.