{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:39:01Z","timestamp":1790865541580,"version":"4.1.0"},"reference-count":22,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2005,9,16]],"date-time":"2005-09-16T00:00:00Z","timestamp":1126828800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiol Young"],"published-print":{"date-parts":[[2005,10]]},"abstract":"<jats:p>\n                    <jats:italic>Aim:<\/jats:italic>\n                    To identify patients with visceral heterotaxy who are at risk from fulminant sepsis.\n                    <jats:italic>Methods:<\/jats:italic>\n                    We studied 38 patients, 37 having undergone abdominal ultrasound, all 38 having examination of blood films to establish presence of Howell-Jolly bodies, and all 38 documented to have had pneumococcal vaccination and prophylaxis with penicillin. We checked whether the parents were aware of the splenic state of their child, and when possible, we compared current results of blood films with those obtained postnatally.\n                    <jats:italic>Results:<\/jats:italic>\n                    Two of the 17 patients with multiple spleens, all 11 without a detectable spleen, and 1 of 9 patients with a normal spleen, showed Howell-Jolly bodies in their blood films. In 5 of 23 patients with serial blood films, Howell-Jolly bodies had not been seen postnatally, but could now be detected in current blood films. Of these patients, 2 had multiple spleens, 1 did not have a spleen, and 1 had a solitary spleen of normal size. In the other patient, ultrasound could not be performed. Only one of these patients was receiving penicillin prophylactically, and had received pneumococcal vaccination. Of the 15 patients in whom Howell-Jolly bodies were present in the blood, only 8 parents knew about the potential risk for infection. Another 7 parents were sure that their child was taking penicillin regularly, and had received pneumococcal vaccination.\n                    <jats:italic>Conclusions:<\/jats:italic>\n                    Howell-Jolly bodies can be found in the blood of patients with visceral heterotaxy independent of the anatomical state of the spleen. As Howell-Jolly bodies can be encountered in the blood of such patients with increasing age, those with multiple and solitary spleens should be monitored regularly to identify those at risk. Parental knowledge of the splenic state, and compliance for prophylaxis using penicillin, and pneumococcal vaccination, were unsatisfactory in our cohort.\n                  <\/jats:p>","DOI":"10.1017\/s1047951105211320","type":"journal-article","created":{"date-parts":[[2005,9,16]],"date-time":"2005-09-16T05:30:47Z","timestamp":1126848647000},"page":"469-473","source":"Crossref","is-referenced-by-count":41,"title":["Splenic state in surviving patients with visceral heterotaxy"],"prefix":"10.1017","volume":"15","author":[{"given":"Bert H. P.","family":"Nagel","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Paul","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Oliver","family":"St\u00fcmper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2005,9,16]]},"reference":[{"key":"S1047951105211320_ref009","doi-asserted-by":"crossref","unstructured":"Rosenberg HK , Markowitz RI , Kolberg H , Park C , Hubbard A , Bellah RD . Normal splenic size in infants and children: sonographic measurements. AJR 1991; 157: 119\u2013121.","DOI":"10.2214\/ajr.157.1.2048509"},{"key":"S1047951105211320_ref017","unstructured":"Padmanabhan J , Risemberg HM , Rowe RD . Howell Jolly Bodies in the peripheral blood of full-term and premature neonates. Hopkins Med J 1972; 132: 146\u2013150."},{"key":"S1047951105211320_ref016","doi-asserted-by":"crossref","unstructured":"Nathan DG . Rubbish in the red cell. N Engl J Med 1969; 281: 558\u2013559.","DOI":"10.1056\/NEJM196909042811013"},{"key":"S1047951105211320_ref022","doi-asserted-by":"crossref","unstructured":"Rubin LG . Pneumococcal vaccine. Pediatr Clin North Am 2000; 47: 269\u2013285.","DOI":"10.1016\/S0031-3955(05)70207-8"},{"key":"S1047951105211320_ref002","doi-asserted-by":"crossref","unstructured":"Uemura H , Yen Ho S , Devine WA , Kilpatrick LL , Anderson RH . Atrial appendages and venoatrial connections in hearts from patients with visceral heterotaxy. Ann Thorac Surg 1995; 60: 561\u2013569.","DOI":"10.1016\/0003-4975(95)00538-V"},{"key":"S1047951105211320_ref013","doi-asserted-by":"crossref","unstructured":"Corazza GR , Ginaldi L , Zoli G , et al. Howell-Jolly body counting as a measure of splenic function. A reassessment. Clin Lab Haematol 1990; 12: 269\u2013275.","DOI":"10.1111\/j.1365-2257.1990.tb00037.x"},{"key":"S1047951105211320_ref021","doi-asserted-by":"crossref","unstructured":"Finn A , Booy R , Moxon R , Sharland M , Heath P . Should the new pneumococcal vaccine be used in high-risk children? Arch Dis Child 2002; 87: 18\u201321.","DOI":"10.1136\/adc.87.1.18"},{"key":"S1047951105211320_ref006","doi-asserted-by":"crossref","unstructured":"Waldmann JD , Rosenthal A , Smith AL , Shurin S , Nadas AS . Sepsis and congenital asplenia. J Pediatr 1977; 90: 555\u2013559.","DOI":"10.1016\/S0022-3476(77)80365-X"},{"key":"S1047951105211320_ref005","doi-asserted-by":"crossref","unstructured":"Hashmi A , Abu-Sulaiman R , McCrindle BW , Smallhorn JF , Williams WG , Freedom RM . Management and outcomes of right atrial isomerism: a 26-year experience. J Am Coll Cardiol 1998; 31: 1120\u20131126.","DOI":"10.1016\/S0735-1097(98)00062-X"},{"key":"S1047951105211320_ref010","doi-asserted-by":"crossref","unstructured":"Siniluoto TMJ , Tikkakoski TA , L\u00e4hde ST , P\u00e4iv\u00e4nsalo MJ , Koivisto MJ . Ultrasound or CT in splenic diseases? Acta Radiologica 1994; 35: 597\u2013605.","DOI":"10.1177\/028418519403500617"},{"key":"S1047951105211320_ref012","unstructured":"Pearson HA . The spleen and disturbances of splenic function. In: Nathan DG , Orkin SH (eds). Hematology of Infancy and Childhood. WB Saunders Company, Philadelphia, 1998, pp 1051\u20131068."},{"key":"S1047951105211320_ref003","doi-asserted-by":"crossref","unstructured":"Cheung YF , Cheng VYW , Chau AKT , Chiu CSW , Yung TC , Leung MP . Outcome of infants with right atrial isomerism: is prognosis better with normal pulmonary venous drainage? Heart 2002; 87: 146\u2013152.","DOI":"10.1136\/heart.87.2.146"},{"key":"S1047951105211320_ref018","doi-asserted-by":"crossref","unstructured":"Murdoch IA , Dos Anjos R , Mitchell A . Fatal pneumococcal septicaemia associated with asplenia and isomerism of the right atrial appendages. Br Heart J 1991; 65: 102\u2013103.","DOI":"10.1136\/hrt.65.2.102"},{"key":"S1047951105211320_ref008","doi-asserted-by":"crossref","unstructured":"Huhta JC , Smallhorn JF , Macartney FJ . Two dimensional echocardiographic diagnosis of situs. Br Heart J 1982; 48: 97\u2013108.","DOI":"10.1136\/hrt.48.2.97"},{"key":"S1047951105211320_ref020","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics. Technical report: Prevention of pneumococcal infections, including the use of pneumococcal conjugate and polysaccharide vaccines and antibiotic prophylaxis. Pediatrics 2000; 106: 367\u2013376.","DOI":"10.1542\/peds.106.2.367"},{"key":"S1047951105211320_ref001","doi-asserted-by":"crossref","unstructured":"Anderson RH , Becker AE . Hearts with isomeric atrial appendages. In: Anderson RH , Becker AE (eds). Controversies in the Description of Congenitally Malformed Hearts. Imperial College Press, London, 1997, pp 67\u2013112.","DOI":"10.1142\/9781848160828_0003"},{"key":"S1047951105211320_ref019","doi-asserted-by":"crossref","unstructured":"American Academy of Pediatrics Policy statement: Recommendations for the prevention of pneumococcal infections, including the use of pneumococcal conjugate vaccine, pneumococcal polysaccharide vaccine and antibiotic prophylaxis. Pediatrics 2000; 106: 362\u2013366.","DOI":"10.1542\/peds.106.2.362"},{"key":"S1047951105211320_ref004","doi-asserted-by":"crossref","unstructured":"Gilljam T , McCrindle BW , Smallhorn JF , Williams WG , Freedom RM . Outcomes of left atrial isomerism over a 28-year period at a single institution. J Am Coll Cardiol 2000; 36: 908\u2013916.","DOI":"10.1016\/S0735-1097(00)00812-3"},{"key":"S1047951105211320_ref011","doi-asserted-by":"crossref","unstructured":"Oleszczuk-Raschke K , Set PAK , von Lengerke HJ , Tr\u00f6ger J . Abdominal sonography in the evaluation of heterotaxy in children. Pediatr Radiol 1995; 25: S150\u2013156.","DOI":"10.1007\/BF03545614"},{"key":"S1047951105211320_ref007","doi-asserted-by":"crossref","unstructured":"Wu M-H , Wang J-K , Lue H-C . Sudden death in patients with right isomerism (asplenism) after palliation. J Pediatr 2002; 140: 93\u201396.","DOI":"10.1067\/mpd.2002.120510"},{"key":"S1047951105211320_ref014","doi-asserted-by":"crossref","unstructured":"Rodin AE , Sloane JA , Nghiem QX . Polysplenia with severe congenital heart disease and Howell Jolly Bodies. Am J Clin Pathol 1972; 58: 127\u2013134.","DOI":"10.1093\/ajcp\/58.2.127"},{"key":"S1047951105211320_ref015","doi-asserted-by":"crossref","unstructured":"Pearson HA , Schiebler GL , Spencer RP . Functional hyposplenia in cyanotic congenital heart disease. Pediatrics 1971; 48: 277\u2013280.","DOI":"10.1542\/peds.48.2.277"}],"container-title":["Cardiology in the Young"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1047951105211320","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,4]],"date-time":"2023-05-04T11:23:54Z","timestamp":1683199434000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1047951105211320\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2005,9,16]]},"references-count":22,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2005,10]]}},"alternative-id":["S1047951105211320"],"URL":"https:\/\/doi.org\/10.1017\/s1047951105211320","relation":{},"ISSN":["1047-9511","1467-1107"],"issn-type":[{"value":"1047-9511","type":"print"},{"value":"1467-1107","type":"electronic"}],"subject":[],"published":{"date-parts":[[2005,9,16]]}}}