Did Spleenectomy works? Can I live Untreated?

My doctors have been trying different types of steroid treatment for example, inyenctions and nothing worked. I have the spleen in 19cm large. My platlets cout still en the 15 and 20's. My doctors say that I will make a Esplenectomy and that with this problem will be solved i sought information and got that taking out the spleen is dangerous and mostly does not work against the ITP! I also have portal hypertension, they made me a shunt spleenorelnal this would help me to upload my platelet but it didn't work. My question is, Can I live wirh ITP without treatment? I really reallu dont want the surgery because the way I see it it will not work! I've been reading and all I read is that the spleenectony works the first weeks and then the platlers cout just drop off! I have itp wince 4 years now and it never bother me I have none systompsI just bleed out a little from the nose just that! And Im a little concernd about rhe surgery. Can anyone pls help me. My surgery is schelude for a month! I had surgery last month My scar ins't heal yet! I am so tired!  My veins hurts Anyone, I recive so many stiches daily! Btw sorry for my english, I usually speak spanish 

Joshy:

Splenectomy for ITP is a choice, not a must. Sometimes it works for an extended period of time and sometimes it does not. Sometimes it can be successful initially and after a few weeks or months, counts drop again.

Many people choose not to treat if they have no symptoms.

Splenectomies can raise the risk of blood clots which might affect your portal hypertension. However, if your spleen is enlarged, it might be wise to have it removed for that reason alone.

José,

Portal hypertension can have a variety of causes, and if there is liver damage this can cause decreased production of a protein called thrombopoietin which sends the signal to your bone marrow to produce platelets1. A shortage of thrombopoietin can cause poor production of platelets, resulting in low platelet counts. In this case, splenectomy might not be helpful, but there are medications you can take, called thrombopoietin receptor agonists, to replace your body's deficient thrombopoietin and thereby increase platelet production.

We have an expression that if the only tool you have is a hammer then everything looks like a nail. So it is with surgeons: they are biased toward surgical solutions for medical problems.

Has your doctor determined the cause of your portal hypertension?

What are your platelet counts? Are your platelets too low to live with, without treating?

If your splenorenal shunt is fairly recent, it will take some time for your spleen to return to normal size, so you may want to give it time to normalize.


(1) www.ncbi.nlm.nih.gov/pubmed/11110614


I should add that when I mentioned thrombopoietin receptor agonists, I was referring to two drugs on the market: eltrombopag (trade name Promacta) and romiplostin (Nplate). You will find many comments about these drugs on this website, usually referred to by their trade names.

Also, here is another good article:
onlinelibrary.wiley.com/enhanced/doi/10.1111/j.1365-2036.2007.03510.x/
Review article: thrombocytopenia in chronic liver disease
F. POORDAD 23 October 2007

I did. I tried all the meds u mention but it dint work any of them! My liver function is 100 porcetb function. They made a liver biopsy and a bone marrow 6 times and all of them came out perfect! The reason for the portal hylertension is unkown. The surguery was march 7 recent but not too much. My platlers count are in the 15-20's all the time! I dont havr systoms just sometimes I bleed from the nouse and its stoop quiclky!

I had a splenectomy nearly 40 years ago and it appears to have worked for me. I have not had so much as a platelet count in all those years and after the initial treatment with prednisone which did not work I had no other treatment past the surgery.

There are probably more of us out there for whom the surgery helped than would be indicated by this forum, I'd be willing to wager.

Hi there!

Spleenectomy was my remission, and I lived completely untreated, from March 1993 until October 2011. Eighteen plus years was a good run.

I would do it again, if I could.

Best of luck to you, friend.
Lourdes

Hi,

I had my spleen removed in Dec 2003 and I´m still in remission.

Rgds,
Erna