HyPOsplenism after splenectomy - what the????

Howdy - had a splenectomy June 2011; no platelet joy followed. I've been on 50 mg Promacta since then, with mixed results. Lately I've been getting IVIG every 3 weeks or so plus continuing the Promacta, while my levels bounce between 4,000 and 714,000. Anyway, my local hema sent me to the Mayo to see if they could recommend something; she suspected perhaps an accessory spleen might be the problem. Mayo doc just called and said there is evidence of hyposplenism and therefore no evidence of Spleen, The Remake - but she seemed very concerned about the hyposplenism and said she would have their pathologists look at it. I was a little rocked and didn't ask why she was concerned, and now I'm fretting. I've looked on the interweb and can't find anything that a layperson could understand about hyposplenism following splenectomy and why it might be worrisome. Seems REASONABLE to me that I would be hyposplenic because - well, you know - no spleen and all. Does anybody have a clue what this might be? I've sent my local hema an email to talk to her Monday but I'd sort of like to sleep between now and then. Any thoughts welcome.

Thanks,all!

Deb

Hyposplenism would indicate that there is no accessory spleen. I don't get the bit where you say "the remake" what does that mean?

They may just be concerned because there is no evidence of spleens but still you have low platelets.

IVIG and Promacta don't mix because you can't tell which is working. Promacta on its own would be a good idea.

Hi, and thanks. They did find a tiny accessory spleen but it isn't large enough to have an impact. Promacta failed, so I'm now on Rituxan with a small steroid chaser. I was being facetious about 'spleen, the remake' because they'd found a spenule...

Oh well thinking about it that makes sense. Asplenia would be no spleen, hyposplenia a small bit. I'd leave it alone and welcome the second chance of considering splenectomy. It may do something and keep you from getting infections.