Acquired functional asplenia. Association with spontaneous rupture of the spleen and fatal spontaneous rupture of the liver in amyloidosis.
A 45-year-old woman who had lower extremity ecchymoses and vague abdominal and back complaints was found to have acquired functional asplenia manifested by Howell-Jolly bodies and poikilocytosis on peripheral blood smear. On spleen scan there was inability to take up radioactive colloid. Shortly thereafter, she was found to have a spontaneous rupture of the spleen. At operation, the spleen, liver, and periaortic lymph nodes were found to be diffusely involved with amyloidosis. Five months later, an acute, serious, intra-abdominal condition developed secondary to spontaneous rupture of the liver, and the patient died. To our knowledge, neither acquired functional asplenia nor spontaneous rupture of the liver has been reported previously in association with amyloidosis.
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