Splenectomy in Sarcoidosis: Indications, complications, and long-term follow-up

Background: Management of splenic enlargement due to sarcoidosis consists of primarily medical therapy with prednisone, methotrexate or antimalarial drugs. Splenectomy is the last resort because of the concern about complications of surgery. Aim: This study was conducted to explore indications for splenectomy in sarcoidosis and to assess if complications associated with splenic removal were unacceptable. Methods/Results: 13 sarcoidosis patients had their spleens removed for one or more of the following four reasons: (1) Massive splenomegaly; (2) Severe hypersplenism; (3) Need for excluding, lymphoma or malignancy; and (4) Precaution against splenic rupture. All patients received strict prophylactic protocol and were followed over a period ranging from I to 30 years. Conclusion: In this long term follow-up study none of the thirteen patients developed serious infections or sepsis. No deaths occurred that might be related to splenectomy.