Does the lack of HJB in an asplenic patient indicate some splenic function?

Question

Hi doctor,

Our son had his spleen removed due to blood loss from a congenital diaphragmatic hernia trauma. While the surgeon was operating they found accessory spleens, but the surgeon was not sure if that will function. We have been on Amoxicillin since discharge. One year later we did a liver spleen scan and they did not find any functional spleens. Two years later we go to a different hematologist for another issue of enlarged lymph nodes and ask about the asplenia. She does some blood working peripheral blood slide and found no HJB and stated there may be some splenic function. She wanted to do a CT scan at 5 years, but she backed off and said only an ultrasound. Ultrasound found nothing.

Is a lack of HJB in an asplenic patient indicate some type of splenic function?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

Normally spleen can remove nuclear remnants containing RBC which stain blue in the smear. So if the spleen is functioning then it is cleared and so Howel's jolly body cannot be seen. But in peripheral smear mistakes can occur and so flow cytometry-based analysis for that can be done to detect if Howel's jolly body contains RBC present or not.

You can discuss this with your treating hematologist for a workup in that case.

Thank you.