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