Hyposplenism in primary systemic amyloidosis.

Twenty-two of 91 (24%) patients with primary systemic amyloidosis were functionally hyposplenic. This group, identified by blood smear findings, had a different survival distribution when compared with a normosplenic group (p less than 0.0001). The peripheral blood smear was more sensitive than the splenic scan for a diagnosis of hyposplenism. Amyloidosis should be included in the differential diagnosis of acquired hyposplenism in the adult.