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Gastroenterology (Expert Forum)
No Spleen
Answered by
Kevin Pho, MD - Internal Medicine
KevinMD.com
This forum is for questions regarding Gastroenterology issues such as Acid Reflux (GERD), Barretts Esophagus, Colitis, Colon/Bowel Disorders, Crohn's Disease, Diverticulitis/Diverticulosis, Digestive Disorders, IBS, Stomach Pain.
No Spleen
by silverangel, Dec 08, 2005 12:00AM
Good day. Need any info on immune system on tx when you don't have a spleen. had a splenectomy 30 yrs ago after a car wreck...had to have multible transfusions to stay alive. Anyway, thats when I got infected with HCV. Recently found out about my hep c, so now I've started tx...2/48. I know tx affects your immune system, so I'm worried how it will affect mine without a spleen. My numbers are also high...geno 1a, vl 6.4 million. My bx showed stage 4 cirrhosis, Stage A...no symptoms, mild activity.
Other than that I'm a 50yr woman in pretty good health...for now. I haven't had any sx yet. Pegasys/copegus. Although, it seems I have symptoms of what I was told would be sx, (aches, tired, and recently hair falling out), except it all started BEFORE tx, but nothing that stops me. I work full time as a LPN in a hospital setting,(that worries me too...germs), and I look pretty good and healthy...looks can be deceiving.
Sometimes it feels like this is the calm before the storm. Hope not. Also, what is the prognosis for someone like me.
Thank you, Sylv
Other than that I'm a 50yr woman in pretty good health...for now. I haven't had any sx yet. Pegasys/copegus. Although, it seems I have symptoms of what I was told would be sx, (aches, tired, and recently hair falling out), except it all started BEFORE tx, but nothing that stops me. I work full time as a LPN in a hospital setting,(that worries me too...germs), and I look pretty good and healthy...looks can be deceiving.
Sometimes it feels like this is the calm before the storm. Hope not. Also, what is the prognosis for someone like me.
Thank you, Sylv
Doctor's Answer
by Kevin Pho, MD, Dec 09, 2005 12:00AM
, Dec 09, 2005 12:00AM
It is true that the treatment with peginterferon (Pegasys) does cause a suppression of the immune system.
However, I am not aware of a specific contraindication in those without a spleen - however, you may want to discuss this with your personal gastroenterologist.
As for the prognosis, that would depend on the ALT levels within the first 8 to 16 weeks of treatment. Another prognostic sign is whether there is loss of the HCV-RNA. A sustained response would be an undetectable HCV-RNA after 6 months.
These considerations should be discussed with your gastroenterologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
However, I am not aware of a specific contraindication in those without a spleen - however, you may want to discuss this with your personal gastroenterologist.
As for the prognosis, that would depend on the ALT levels within the first 8 to 16 weeks of treatment. Another prognostic sign is whether there is loss of the HCV-RNA. A sustained response would be an undetectable HCV-RNA after 6 months.
These considerations should be discussed with your gastroenterologist.
Followup with your personal physician is essential.
This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.
Kevin, M.D.
kevinmd_b
