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Follow up question from June 9th response
Jun 20, 2001

Judith, Thanks for your answer to my question of June 9 "Weight shift from legs to abdomen". You wondered about whether my t-cells at 1300 were "artificially high"..and asked if my spleen was removed. Yes, it was removed in 1991 following an episode of ITP. I'm very concerned!! I've been so proud of my high t-cell counts ever since my diagnosis in 97 (in the middle of round 3 of CHOP for lymphoma). I have no good baseline due to the chemo, but recall the t-cells at around 350 at that time and viral load at about 50,000. Truly, it has been nothing but undetectable and t-cells above 1200 since then...what is the deal with my not having a spleen? Not one physician (very good ones) has suggested that this could be causing "artificially" high counts.....Please don't burst my bubble but what's the association????? Thank you very much Private e-mail

Response from Dr. Aberg

Having your spleen out changes your absolute number of white blood cells. In interpreting what your "adjusted" CD4 is , your doctor should follow your percent. The percent will give a better correlation of what your immune status is. Sorry to "burst your bubble" but it is important to recognize what your CD4 counts represent. Ask your doctor what your percent of CD4 is . Individuals without their spleen should be on PCP prophylaxis if their CD4 percent is less than 14%. There are medical papers describing this and you may want to discuss this issue with your doctor.

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