Splenic radionuclide scanning and sequestration of thermally altered erythrocytes in hepatosplenic sch istosomiasis.

Using heat-treated 51Cr tagged red cells radionuclide scanning of the spleen was performed in 17 patients suffering from hepatosplenic schistosomiasis. Furthermore, following the injection of the thermally damaged erythrocytes, the disappearance half time of radioactivity was calculated from splenic radioactivity build-up tracings. Out of the 17 bilharzial patients examined, 12 had disappearance half times shorter than the lowest limit obtained in normal subjects, denoting exaggerated splenic trapping of heat-treated red cells. Analysis of the results showed that the rate of trapping of heated erythrocytes was more rapid in patients presenting with bigger splenic enlargement, as well as in those having more marked anemia. This might be taken to indicate a possible link between the occurrence of anemia and the spleen in schistosomiasis. By radionuclide scanning, the bilharzial spleen was bigger than normal. In addition, the splenic shadow appeared to be either oval, triangular or kidney shaped. In 9 patients, the distribution of radioactivity was homogenous, with decrease in the density towards the periphery. In the remaining 8 cases, patchy distribution of radioactivity was observed. Mottling was more marked in the huge spleens as well as in the presence of severe anemia.