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Spontaneous rupture of spleen in a HIV seropositive non- thrombocytopenic patient.
Pesce A; Vinti H; Taillan B; Fuzibet JG; Dujardin P; Cassuto JP;
September 30, 1990
Int Conf AIDS. 1989 Jun 4-9;5:484 (abstract no. B.524). Unique

We recently observed a case of rupture of the spleen, in a HIV seropositive asymptomatic and non thrombocytopenic patient in relation with a large spontaneous splenic hematoma. A 25-year- old male patient, intravenous drug abuser from 1982 to 1984, HIV seropositive since February 1986 and regularly followed without any symptoms, presents with abdominal pain and deglobulization. There was no abdominal traumatism. Echography and CT. scan showed mild splenomegaly with heterogeneous zones, and intraperitoneal blood. There was not any alteration of hemostasis. Platelets were 218 x 10.9/1. Patient did not take any drugs or toxic, and there were no signs of opportunistic infection. Splenectomy was performed: spleen was large, 460 g weight, with rupture on inferior pole and a 4 cm circumference hematoma. On microscopy there was a follicular hyperplasia commonly observed in HIV seropositive patients. The research of disease responsible of spleen rupture was negative. Actually, patient remains well and his HIV status is always asymptomatic. Spontaneous rupture of the spleen has been described in a lot of affections, frequently of viral origin. In our patient the research of any cause of spleen rupture is negative, and not any alteration of hemostasis, frequently observed in HIV positive patients such as thrombocytopenia and/or circulant anticoagulant was found. However, generalized lymphadenopathy and splenomegaly are well known in HIV seropositive patient, and this chronic viral portage may be responsible for spleen damage followed in rare cases by spleen rupture.

Adult Hematoma/COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY Human HIV Seropositivity/*COMPLICATIONS/DIAGNOSIS Male Rupture, Spontaneous/COMPLICATIONS/DIAGNOSIS/MICROBIOLOGY Splenectomy Splenic Rupture/COMPLICATIONS/DIAGNOSIS/*MICROBIOLOGY Ultrasonography ABSTRACT

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