IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 17, Issue 7 Ver. 13 (July. 2018), PP 61-64 www.iosrjournals.org DOI: 10.9790/0853-1707136164 www.iosrjournals.org 61 | Page Ultrasonographically Determined Autosplenectomy Rates In Nigerian Sicklers And The Predictors Running Title: Splenic Changes In Nigerian Sicklers *Grace B. Inah +Emmanuel E. Ekanem *Department Of Radiology, University Of Calabar, And University Of Calabar Teaching Hospital, Calabar, Nigeria. +Department Of Paediatrics, University Of Calabar, And University Of Calabar Teaching Hospital, Calabar, Nigeria. Correspondence Author: Ekanem EE. Abstract Background: At birth, the spleen in sickle cell anaemia patients (SCA) is normal in size and function. With increase in age, there are repeated vaso-occlusions, multiple infarctions and splenic fibrosis resulting in atrophy and autosplenectomy. Early monitoring and detection are enhanced by ultrasonography of the spleen because the spleen responds to different pathologic states such as fever and SCA by dimensional and parenchymal changes. Objective: This study aims to determine the prevalence of autosplenectomy by abdominal ultrasonography in SCA patients in Calabar, Nigeria. Methods: A prospective study of 120 patients was carried out between January to June, 2018. Sociodemographic data was collected on each patient prior to physical examination. Abdominal ultrasonography examination was performed on all the recruited patients. Splenic longitudinal and transverse dimensions were measured and echogenicity documented. Results: The median of age of the sickle cell subjects was 14.5% years. Out of the 120 sickle cell subjects 69(57.5%) were males while 51 (42.5%) were females. The prevalence of autosplenectomy was 32.5% and was higher with increasing age. There was no difference in splenic size by gender. Only 1(0.83%) of the study had splenomegaly and 3(2.5%)had splenic atrophy. The youngest patient with SCA was 9 years old. Conclusion: Autosplenectomy is a common finding in SCA patients and it increases with age. As survival improves in SCD in Nigeria, autosplenectomy rate is increasing. A review of the vaccination programme forsicklers with possible booster doses of vaccines such as the pneumococcal vaccine in adolescentsand adulthood is recommended. Key Words:Autosplenectomy, Sickle Cell Anaemia, Ultrasonography. --------------------------------------------------------------------------------------------------------------------------------------- Date of Submission: 12-07-2018 Date of acceptance: 27-07-2018 --------------------------------------------------------------------------------------------------------------------------------------- I. Introductions Sickle cell disease (SCD) is a common autosomal recessive genetic disorder of the blood characterized by a defective form of haemoglobin (Hb) synthesis with production of an abnormal form known as sickle haemoglobin (HbS). 1,2 It is among the most common of the inherited haemoglobinopathies. The spleen is the most frequently affected organ in SCD mainly due to its reticuloendothelial function and complex anatomy. 3,4 It has a slow tortuous microcirculation that favours sickling of red blood cells and as a consequence splenic infarctions are very common. 5,6 With increase in age, there are repeated vaso-occlusions, multiple infarctions and splenic atrophy. 7 The spleen is eventually reduced to a siderofibrotic mass. This process occurs at about 6-8years and is known as auto-splenectomy. Usually by the eight-year, most SCA patients do not have a clinically palpable spleen. 7 In the tropics however, splenomegaly may persist into adulthood due to tropical splenomegaly syndrome resulting from the malaria parasite. 8 Focused clinical follow-upand the gradual introduction of a broad range of life saving measures (including penicillin prophylaxis, vaccination for common bacterial diseases, training of parents to detect splenic sequestration events and provision of disease-modifying treatment with hydroxy-urea) andvaso- occlusive episodes and have led to an increased life expectancy among people with SCD in many affected countries. Hence, older people with complications are now seen. 9,10 It is important therefore to define changes in the spleen in this emerging scenario.