Splenomegaly, Enlarged Spleen - Causes, Symptoms, Diagnosis & Treatment

Splenomegaly: Enlarged Spleen

Dr.Subba Rao Kanchustambam profile Authored by Dr.Subba Rao Kanchustambam on 13 Mar 2015 - 15:45.

Spleen

Splenomegaly is a condition characterized by enlargement of the spleen. The enlargement of the spleen may result from various conditions like infections and cancer of the liver. As such, enlarged spleen does not present with typical signs and symptoms, but some people may experience a wide range of varying symptoms.

The spleen is an organ of the lymphatic system and its located right below the ribs within the upper left part of the peritoneal cavity. It plays important roles in immunosurveillance (a process by which immune system recognizes foreign body), hematopoietic (production of blood cells), removes abnormal red blood cells, formation of Ig G (immunoglobulin G), etc.

The length of a normal spleen is noted to be 11 cm (approx.) while it weighs approximately 150 g and is not palpable. The spleen weighing more than the normal range, usually about 400 to 500 gor more and length more than 11 cm signifies the enlargement of the spleen (Splenomegaly). 

Splenomegaly may result from a variety of underlying clinical conditions and infections. Some major factors believed to cause enlargement of the spleen may include:

  • Infections: These may include viral, bacterial, and parasitic infections e.g. Infectious mononucleosis, syphilis, malaria,cat-scratch fever, etc.
  • Liver cirrhosis
  • Other conditions affecting liver e.g. Liver cancer, cholecystitis, fatty liver diseases, etc.
  • Premature loss of RBCs (hemolytic anemia)
  • Different types of blood cancers including leukemia and Hodgkin’s disease
  • Thalassemia 
  • Gaucher's disease (genetic disorder causing accumulation of fatty substances in specific cells and/or organs).
  • Niemann-Pick disease (it is a lysosomal storage disease affecting multiple organs).
  • Connective tissue disorders
  • Systemic lupus erythematosus (it affects almost 10% of patients with lupus)
  • Trauma or injury to the liver
  • Occurrence of cysts
  • Strawberry mark or Strawberry hemangiomas

Enlarged spleen alters many vital functions, predominantly blood filtration causing deficiency of healthy red blood cells (RBCs) and many more. An outgrowth of an enlarged spleen may also damage the section of the organ.Most patients with enlarged spleen may not cause any symptom, but some may present with following signs and symptoms:

  • Abdominal pain
  • Feeling of fullness in the left upper abdomen (without eating)
  • Radiating pain towards shoulders
  • Anemia
  • Fatigue
  • Frequent infections
  • Excessive blood loss even with minor injuries

When to see a doctor?

One should be always alert about the abnormal symptoms in the body and should immediately seek medical attention. In case of Splenomegaly, following are the alarming signs that demands a visit to the doctor:

  • Abdominal pain (on the upper left side) that often worsens with deep breathing
  • Unable to eat large portions

 

As most of people with enlarged spleen may remain asymptomatic, it is often diagnosed accidently during routine exams. However, diagnosis of enlarged spleen in “high risk” group may involve a series of tests. These may include:

  • Assessment of personal and family medical history for any genetic disorder, immune disease or any other high risk disease.
  • Physical exam - enlarged and tender spleen can be felt from outside the upper left abdomen.
  • Blood exam:to check for abnormal count of blood cells, including, WBCs, RBCs and platelets.
  • Imaging tests – CT scan or ultrasound may be considered to examinespleen enlargement.
  • MRI – To keep track of blood flowing through the spleen.

The above mentioned diagnostic tests do not reveal the cause of Splenomegaly. To reveal the cause, following tests may be recommended:

  • Liver function tests – To look for any liver disease or condition that might be affecting the spleen.
  • Bone marrow exam and bone marrow biopsy
  • Microscopic exam of the sample from removed spleen to look for lymphoma.

The following factors may increase the risk of spleen enlargement:

  • Having an infection/s inthe early years of lif
  • Having any inherited metabolic disorder
  • Travelling to areas where infection/s is endemi Living in crowded and unhygienic places

Complications:

  • Timely management with the right approach can prevent the Splenomegaly from causing other complications. However, if left untreated or poorly managed, Splenomegaly can lead to:

  • Cytopenia (reduced production of blood cells).

  • Increased risk of frequent infections (due to deficiency of platelets and white cells in the body).

  • Excessive bleeding

  • Increased risk of spleen rupture, causing abdominal bleeding that might be life-threatening.

Most of patients may not need any specific treatment unless they experience significant symptoms. Treatment of symptomatic patients involves assessment of the cause of an enlarged spleen and treating the cause with most effective and suitable approach. While the primary aim of the treatment is to relieve the irritating and worrying symptoms. Based on the cause revealed and individual’s condition, experts may choose any of the following treatment approaches:

  • Drugs and medications: Antibiotics may treat bacterial infections, other drugs to treat liver disease, chemotherapy to treat cancer, medicines to manage genetic metabolic diseases, etc.
  • Surgery(splenectomy): It is often considered when an underlying cause remains unknown, leaving the only option behind to manage the condition. Although one can enjoy normal life after spleen removal, individual becomes prone to various infections very easily.
  • Radiation therapy: To shrink the spleen (often considered as a replacement of splenectomy).

Alternative medicine:

Homeopathic Medicines: Several medicinal preparations may be useful; these may include Ceanothus L., Hydrastis Canadensis, Iodine, China, Arsenicum Album, etc.

(Note: Do not consume these herbal preparations on your own. Talk to a medical professional before making any choices.)

Lifestyle interventions and home remedies:

  • Avoid contact sports e.g. Football, hockey, etc.
  • Limit activities like going to crowded markets, crowded communities, etc.
  • Modify your activities (as recommended by the doctor) to prevent further complications.
  • Get vaccinated against common communicable infections like flu, pneumonia, etc.
  • Wear a seat belt to prevent spleen injury.

 

*Disclaimer This is not medical advice. The content is for educational purposes only. Please contact your doctor for any health care issues.