Q: My father aged 63 has splenomegaly (20+ cm). His coombs test is +ve showing AIHA. His retic count is 8. Hb is 7. Platelets are around 60,000. Bone marrow test is fine. No cause of spleen enlargement could be detected till now. He has been advised splenectomy. Is it right to go for it? Before surgery to bring up the Hb, would it be alright to give him blood transfusion or should steroids be given?

A:The blood test results are suggestive of haemolysis and your fathers red blood cells are being destroyed by his enlarged spleen .Removal of the spleen especially when it is very much enlarged is the right treatment. It should be safe for him to receive blood transfusion during surgery.