Blood, 1946, Vol. 1, No. 1, pp. 10-26.
© 1946 American Society of Hematology, Inc.
PRIMARY CONGENITAL AND SECONDARY ACQUIRED SPLENIC
PANHEMATOPENIA
CHARLES A. DOAN M.D.1 and
CLAUDE-STARR WRIGHT M.D.1
1 Department of Medicine, Ohio State University, Columbus, Ohio.
1. The spleen is an organ of multiple structures and many functions, but in the
interests of human health and disease, it is probably far more important pathologically than physiologically.
2. It has been abundantly proved that instability in splenic functional balance
toward any one of the essential elements of the blood passing through this organ
may be an inherited trait, as in congenital hemolytic icterus. Recognition is now
made of a syndrome in which, despite intensive compensatory panmyeloid hyperplasia, indiscriminate elimination of all circulating elements occurs, actually
simulating panmyeloid hypoplasia. Splenectomy in such a syndrome is often dramatically curative. "Primary splenic panhematopenia" is suggested as an appropriate descriptive designation.
3. The potentially important role which may be played by the spleen, secondarily involved in a wide variety of syndromes, with the precipitation of varying
degrees of peripheral cellular disequilibria, demands careful diagnostic discrimination. A dependable experience in the specific technics by which bone marrow and
splenic functions are appraised is essential to sound judgment and clinical acumen.
4. The normal spleen is apparently not essential to life and health at any age and,
therefore, may be surgically removed without prejudice to future hemolytopoietic
equilibria and longevity. The pathologic spleen may at times constitute a very real
hazard to health and an actual threat to survival; in the more acute syndromes,
prompt surgical intervention may be lifesaving.
