Bilharzial hepatic fibrosis, usually accompanied by marked enlargement of the spleen, leukopenia, thrombocytopenia, and hypochromic anemia, is endemic in Egypt.1 The possibility that the enlarged bilharzial spleen may acquire hypersplenic activity and cause hemolytic anemia has been discussed by workers from Egypt2 and elsewhere3; however, no convincing evidence to prove this has been reported in the literature. Recently, Jandl et al4 have described a method for determining the sites of red cell destruction by using Cr51. We have used this technique to study the Cr51 red cell half-survival time and the uptake of radioactivity by the spleen, liver, and precordium in four patients with proved bilharzial hepatosplenomegaly. In addition, other hematological and biochemical tests were carried out. In none of these patients did we produce evidence of anemia due to hypersplenism.
Methods and Materials
Four patients with marked hepatosplenomegaly were studied. Liver biopsy, performed