
The spleen, the strange little organ that can multiply - Meerax
http://www.npr.org/sections/health-shots/2016/12/13/505349283/meet-the-spleen-the-strange-little-organ-that-can-multiply
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Asparagirl
Oh hey, this is me! I had two accessory spleens. But the bad news is that ALL
of them absolutely had to come out -- the accessories were discovered during a
medically necessary splenectomy.

As the article says, the spleen filters your red blood cells and platelets.
Think of it like a swimming pool filter for your blood stream. It knows which
cells to break down because they're misshapen, spherical, instead of the
"donut without a hole" shape. RBC's live about three months before degrading
like that.

There's just one problem: what happens if your red blood cells are ALL funny-
shaped, even the young healthy ones? Why then, your spleen valiantly tries to
catch 'em all, like Pokémon, and you end up breaking down your own blood
supply, auto-hemolytic anemia.

Welcome to hereditary spherocytosis, which is what I have. Despite its name,
it was not hereditary in my case; about 25% of cases are de novo mutations.
Incidence is about 1 in 6500, though some milder cases go undetected.

So, after a childhood of jaundice at birth, inexplicable anemia, paleness, and
just being really really tired all the time, finally at age six did my
pediatrician notice that my spleen was massively enlarged (due to working
overtime) and two years later I had to have it out, along with the two
accessories they discovered on the operating table. This was the late 1980's
so I juuust missed the beginning of the era of laparoscopic surgery, so I have
a heck of an abdominal scar.

Poor little spleen, it was only trying to do its job. The fault lay with my
blood, not with it.

Meanwhile, I'm immune-compromised for life and have to stay on top of all
kinds of vaccines. Note to other spleenless wonders posting here: there's a
brand new Meningitis Type B vaccine that just came out in late 2014; get on
that. Also Prevnar, Pneumovax, annual flu shots and all the other fun stuff.

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kahrkunne
>finally at age six did my pediatrician notice that my spleen was massively
enlarged (due to working overtime)

Who was working overtime here? Six year old you or the pediatrician? Neither
makes sense to me.

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heimdall
The spleen was the one working overtime, since it would normally be filtering
a fraction of his blood that was problematic, but instead 100% of his blood
'needed' to be filtered.

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Asparagirl
*her (see username)

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shakna
I had a secondary spleen, nestled right up against my main one that I tore
completely in half in primary school.

Subsequent testing over the next five years showed it, sadly, failed to become
active.

For people like me, getting your inoculations is imperative. Annual gp visits
help keep it in check.

As for the rest, depending on herd immunity is the answer.

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niels_olson
Hey, those innoculations aren't the end of the story. I was involved with a
patient who went swimming in a waterfall pool in Hawaii and came down with
leptospirosis. He didn't mention to his primary care provider that he'd had a
splenectomy (and the provider documented other surgical history, so not sure
why he omitted that, probably just forgot).

His 9 friends didn't get sick. But they had spleens. He ended up intubated in
the ICU and became sufficiently well known in certain circles that I have had
conversations with doctors involved in his care on both coasts. Which means he
was a terribly interesting patient.

You never, ever want to be an interesting patient...

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pacaro
Leptospirosis is seriously nasty. I know kayakers who've had doctors not take
their risk level seriously ("Hi doc, I was kayaking in this nasty canal and
now I have flu like symptoms, please check for leptospirosis", "Nah,
leptospirosis is rare and the test are expensive"). An extended stay in ICU
resulted for a couple of them.

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pacaro
Shame that the article doesn't mention how we know so much about long term
survival rates of people with no spleen. IIRC During the Second World War (aka
WWII) large numbers of injured soldiers had their spleens removed in passing,
this gave a large population to follow

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mikeash
Does "in passing" mean they got removed unnecessarily, just because they were
already being operated on, or is it something else?

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rajuvegesna
Nothing was mentioned about multiple spleens at birth (Polysplenia). Yes, some
people are born with multiple spleens. In such case, it has nothing to do with
injury and there doesn't seem to be enough knowledge on why this occurs.

Multiple spleens often result in mis-diagnosis (during radiology) leading to
wrong treatment. When you know you have accessory spleens, it is always good
to give them a heads up.

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justinator
Any research done to nudge these spleen cells into making other types of cells
(stem)?

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rcthompson
How would this be better than just using stem cells?

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neighborinooo
I know that we have embryonic stem cells (controversial) and adult stem cells
that can be harvested from skin tissue (not controversial, possibly
difficult/expensive?). I'm not particularly well versed in this field, but it
could possibly be more expedient than other methods of getting adult stem
cells. It could also be even more difficult/expensive, and that's assuming
that they're pluripotent and not spleen-specific in the first place, though.

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stcredzero
A housemate of mine used to call herself "The spleenless wonder." It was
removed after a car accident.

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berntb
I got just one extra spleen (small, one percent of the population or so have
that. Edit: at least that was what the doctor told me; TFA said 20%).

I call myself "splenically superior" and argue that it obviously explains my
mean personality. :-)

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jcoffland
The article says your chances of having an extra spleen are one in five.

