Spleen acts as a master lymph node

Dear Dr. Roach: My 35-year-old son died recently of a sepsis infection that quickly overtook his organs within days.

While he was in the intensive care unit, tests showed he was born without a spleen, which ultimately resulted in his death.

How often is someone born without a spleen? We wish we would have known.

L.E.E.

Answer: I am very sorry to hear about your son.

Sepsis is a complication of serious infection. It’s an abnormally exaggerated body response to infection, usually from bacteria.

People can die from sepsis very quickly, especially if they have risk factors.

Common risk factors include a depressed immune system due to cancer or treatment with medications that suppress the immune system, but not having a spleen is certainly a risk factor.

In addition to its job in clearing out old red blood cells, the spleen acts as a kind of master lymph node, where the cells of the immune system interact with each other, improving the body’s ability to fight off infection.

Most people without a spleen have had it surgically removed, whether as treatment for a blood disorder or due to trauma.

People with sickle cell disease lose their spleen early in life because of progressive damage done by the abnormal blood cells and should be considered to have no functioning spleen.

Congenital asplenia (being born without a spleen) is extremely rare, with estimates of it happening less than one person per million. There is no way you could have known about this unless he had happened to have a scan for some other reason.

A mnemonic aid for recognizing sepsis has been established:

Slurred speech or confusion;

Extreme shivering or muscle pain, fever; Passing no urine all day; Severe breathlessness; It feels like you’re going to die;

Skin mottled, discolored. People with these symptoms, especially those with risk factors, should immediately seek medical attention and tell their provider they are concerned about sepsis.