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While thrombosis is a known post-splenectomy consequence, our findings indicate a significant increase in platelet activation, hypercoagulation, serum ferritin as well as the up-regulation of platelet proteins in non-splenectomized patients, suggesting a closer monitoring of thrombosis in this group of patients is also needed

Unresolved questions It remains to be established whether CNS symptoms reported in some patients with gamma-glutamylcysteine synthetase are related to the enzyme defect or not