Splenomegaly: What Causes An Enlarged Spleen?

What Is Splenomegaly?

enlarged spleen

Splenomegaly refers to an enlarged spleen. It is not typically a condition on its own, but occurs as the result of an underlying condition. Normally, the spleen is the size of a clenched fist. When an individual has splenomegaly, the spleen increases in size either mildly or so significantly that it can rupture and lead to a medical emergency.

Causes

Splenomegaly can occur as the result of a temporary illness or trauma.  It can also occur as the result of an underlying chronic condition including, but not limited to, the following

  • Epstein-Barr Virus
  • Toxoplasmosis
  • Endocarditis
  • Cytomegalovirus
  • HIV/AIDS
  • Hepatitis
  • Lymphoma
  • Leukemia
  • Rheumatoid Arthritis
  • Lupus
  • Abdominal Trauma
  • Gaucher’s Disease
  • Amyloidosis
  • Hemolytic Anemia
  • Sickle Cell Disease
  • Thalassemia
  • Spherocytosis
  • Portal Hypertension
  • Liver Disease
  • Congestive Heart Failure
  • Cancer That Has Metastasized to the Spleen
  • Hurler Syndrome
  • Niemann-Pick Disease
  • Tuberculosis
  • Malaria
  • Anaplasmosis

splenomegaly

Types

There is only one type of splenomegaly.

Symptoms

Some of the symptoms associated with splenomegaly may actually stem from the underlying cause of the enlarged spleen. This can include:

  • Indigestion
  • Abdominal pain
  • Poor appetite
  • Hiccups
  • Back pain
  • Fatigue
  • Weakness
  • Shortness of breath
  • Excessive bleeding
  • Yellowing of the skin and eyes
  • Easy bruising
  • Heavy menstrual periods

Diagnosis

abdominal ultrasound

An abdominal ultrasound can reveal splenomegaly. The enlarged spleen is pictured here in purple.

There are several ways to diagnosed splenomegaly. Your doctor may be able to palpate an enlarged spleen on a physical exam. To confirm that your spleen is enlarged, your doctor will send you for diagnostic imaging. This may be an abdominal ultrasound, CT (computed tomography) scan, or MRI (magnetic resonance imaging) scan. If diagnostic imaging confirms that you have a splenomegaly, your doctor will order various tests to determine the underlying cause of the enlarged spleen. This will likely include blood panels to check for infections such as Epstein-Barr or hepatitis.

Treatment

In mild cases of splenomegaly that are caused by viral infections, the spleen will usually shrink back down to its normal size after some time. In other cases, the spleen will reduce down to its normal size when the underlying cause has been managed or resolved.  In more severe cases, due to trauma or chronic conditions, the spleen may continue to enlarge until it ruptures. This is considered a medical emergency and will lead to death if left untreated. Severe splenomegaly can also lead to significant blood loss and anemia. In serious cases like this, a splenectomy needs to be performed. A splenectomy is a surgical procedure to remove the severely enlarged spleen.

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