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

Figures & data

FIGURE 1. Brain MRI of a patient with Wilson's disease. A, D: T1WI reveals a symmetric low signal in the bilateral basal ganglia; B, E: T2WI reveals a symmetric high signal in the bilateral basal ganglia; C, F: Axial fluid attenuated inversion recovery (FLAIR) MRI reveals a symmetric high signal in the bilateral basal ganglia.

TABLE 1. Clinical characteristics of hypersplenic patients with WD before PSE or splenectomy (means ± SDs)

Variables	Group A	Group B	P value
Patients (n)	25	25	> 0.05
Average age (years)	22.00±7.2	20.7±6.48	> 0.05
Gender (M/F)	16/9	14/11	> 0.05
Liver function
ALT (U/L)	75.79 ± 8.66	73.47 ± 9.33	> 0.05
AST (U/L)	71.52 ± 8.35	73.52 ± 8.44	> 0.05
TB (µmol/L)	24.42 ± 3.61	26.68 ± 2.18	> 0.05
A/G	0.96 ± 0.13	0.93 ± 0.19	> 0.05
WBC (×10^9/L)	2.17 ± 0.91	2.21 ± 0.87	> 0.05
PLT (×10^9/L)	57.57 ± 13.57	56.90 ± 14.38	> 0.05
Serum ceruloplasmin (g/L)	0.075 ± 0.032	0.077±0.038	> 0.05
24-hr urinary copper excretion (µg/24 h)	1032.769±783.970	935.124±571.877	> 0.05
Neurologic (n)	25	25	> 0.05
KF rings (n)	25	25	> 0.05
Brain MRI abnormalities of WD (n)	25	25	> 0.05

WBC, white blood cell; PLT, platelet; ALT, alanine aminotransferase; AST, aspartate aminotransferase; TB, total bilirubin; WD, Wilson's disease.

FIGURE 2. Splenic artery angiography before (A, B) and after (C, D) embolization.

FIGURE 3. Computed tomography (CT) of the abdomen after embolization. The low-density region represents the infarcted area of the spleen.

FIGURE 4. Changes in the WBC and PLT counts before and after PSE (group A, n = 25) or splenectomy (group B, n = 25). Values are expressed as the means ± standard deviations. ^*Significant increase at the indicated time point (7, 14, 21, 28, or 35 days after the procedure) compared with the pre-PSE or pre-splenectomy values in each group (^*P < 0.05).

FIGURE 5. Changes in liver function parameters before and after PSE (group A, n = 20) or splenectomy (group B, n = 20). Values are expressed as the means ± standard deviations. Pre: before PSE or splenectomy; post: after PSE or splenectomy (^*P < 0.05).