Recurrence of hemolysis in hereditary spherocytosis: A case due to leukemic infiltration of an accessory spleen

A patient with hereditary spherocytosis, treated eight years previously with splenectomy, presented in relapse. Subsequent investigation demonstrated an accessory spleen as well as oligoblastic leukemia. The latter evolved to acute myelomonocytic leukemia resulting in the patient's death. Leukemic infiltration of an accessory spleen was demonstrated after autopsy. The relationship between the evolving leukemia, appearance of an accessory spleen, and relapse of hemolysis is considered. Additionally, the role of radioisotope scanning in the investigation of recurrent hemolysis in splenectomized patients is illustrated.