Hypersplenism

Hypersplenism spleen

Last Updated October 23rd, 2019

The most common symptom of hypersplenism is anemia. This is because an enlarged spleen causes widespread breakdown of RBCs. This can further cause fatigue and shortness of breath. Other symptoms of hypersplenism are- pain in the left abdomen, feeling of fullness in the said region, recurring (or frequent) infections, and general weakness. However, in many cases hypersplenism might not result in any noticeable symptoms at all.
Hypersplenism or enlarged spleen can occur due to a variety of reasons such as viral infections, metabolic disorders, trauma to the spleen, etc. It has been observed that a number of liver conditions can also cause hypersplenism. Liver cirrhosis, hepatitis C, portal hypertension - all of these liver diseases increase the risk for hypersplenism. Such conditions increase the blood pressure inside the spleen and thus increase the risk of an enlarged spleen.
If the spleen enlarges beyond a certain level, it can create pressure on the surrounding tissues and organs and turn painful. The pain of hypersplenism is often described as that of fullness and discomfort on the left part of the chest and abdomen. But in many cases, it might not be painful at all.
The human spleen is an organ completely dedicated to regulating immune responses within the body. When you catch malaria, the spleen generates immune signals to fight the disease-causing parasite. In case of frequent bouts of malaria over a long period of time, the spleen becomes massively over-worked and enlarged. This is also known as tropical splenomegaly syndrome.

What Is The Spleen?

The spleen is an important lymphatic organ that performs a number of diverse functions. One of its main functions is to filter out worn out cells, bacteria and foreign contaminants from the bloodstream. Old red blood cells filtered out in this way still contain hemoglobin which is then metabolized or broken down by the spleen. This organ also contributes towards maintaining your immunity. It does so by producing new white blood cells and keeping them in store, ready to be released in the event of infection or injury. Your spleen also produces certain kinds of antibodies, substances that play an important role in disabling pathogens.

Hence, any disorder or disease that affects or damages your spleen can impair all of these important functions. Often, the spleen is adversely affected by liver disease or by severe infection. When the organ is overworked, it can become abnormally enlarged. This condition is known as splenomegaly and it can lead to further complications. One of the main features of splenomegaly is Hypersplenism.

What Is Hypersplenism?

Hypersplenism locationOne of the adverse outcomes of having an enlarged spleen is that the organ becomes hyperactive. Accordingly, this condition is known as hypersplenism. While its normal function involves filtering out worn-out blood cells, an overactive spleen will decommission blood cells at an abnormally rapid rate, even pulling out or sequestering healthy ones from the bloodstream. Since the enlarged spleen keeps blood cells trapped for extended periods of time, the overall result is a deficit of healthy blood corpuscles in circulation.

This shortage of blood corpuscles is known as cytopenia and it can take different forms depending on which type of blood cell is involved. The deficit of red blood cells is known as anemia. Shortage of white blood cells is called leukopenia and the shortage of platelets is known as thrombopenia.

What Causes Hypersplenism?

To put it simply, a larger spleen is a more active spleen. What a healthy spleen can achieve in a certain amount of time can be achieved by an enlarged one in a shorter period of time. Most often, splenomegaly is associated with liver problems but there can be other causes as well. For instance, having an autoimmune disorder, or an inflammatory disease like lupus can lead to enlargement of the spleen as a result of inflammation.

Any condition that forces the spleen to work overtime could be responsible for splenomegaly. For instance, when a person is suffering from blood cancer, their blood contains an unusually large quantity of abnormal cells that the spleen must work extra hard to filter out. Similarly, a severe infection destroys large numbers of white blood cells. Hence, the spleen must work harder than usual to get rid of this cellular debris and even any microbes that might be present in the blood.

What Are The Risk Factors?

Hypersplenism spleenAny scenario that puts you at risk of developing splenomegaly is, by extension, also a risk factor for hypersplenism. Some of these are listed below:

  • Infections including viral diseases such as infectious mononucleosis, bacterial infections such as syphilis, tuberculosis, and endocarditis as well as infectious parasitic diseases such as malaria and schistosomiasis.
  • Liver disease such as cirrhosis, viral hepatitis, Budd-Chiari syndrome, cystic fibrosis and portal hypertension.
  • Anemia associated with conditions like hereditary spherocytosis, thalassemia and sickle cell disease.
  • Metabolic disorders such as Gaucher disease and amyloidosis.
  • Tumors in the spleen or those that have extended to the spleen from other locations.
  • Cysts in the spleen.
  • Trauma to the spleen.
  • Heart failure.
  • Cancers including the various types of leukemias, lymphomas, and polycythemia vera.
  • Myeloproliferative disorders such as myelofibrosis.
  • Vascular conditions such as obstruction of the hepatic vein, portal vein or the splenic vein.
  • Autoimmune disorders like rheumatoid arthritis and systemic lupus erythematosus.
  • Certain medications or drugs.

What Are Some Symptoms Of Hypersplenism?

While white blood cells and platelets may be released safely after a temporary entrapment in the spleen, red blood cells that are trapped in the spleen will be broken down or ‘lysed’. This leads to a condition known as hemolytic anemia. If this becomes serious enough to be clinically significant, the patient will end up feeling tired, weak, and short of breath.  More symptoms are discussed below:

  • A sensation of fullness in the upper abdomen.
  • This may be accompanied by pain in the upper abdomen or the area of the back corresponding to the location of the spleen.
  • Feeling full without having eaten much. This happens because the distended spleen is putting pressure on the stomach.
  • Feeling tired.
  • Shortness of breath.
  • Frequent infections.

What Are The Different Types Of Splenomegaly?

Depending on the nature of the process that leads to enlargement of the spleen, splenomegaly may be classified under a number of different headings, as described below in brief:

  • Infectious splenomegaly: As the name suggests, this condition arises on account of infectious diseases which cause the spleen to become overworked.
  • Inflammatory splenomegaly: In this case, the spleen is affected by autoimmune-related inflammation or even infection. Examples include diseases such as systemic lupus erythematosus and juvenile rheumatoid arthritis.
  • Hyperplastic splenomegaly: Conditions such as myeloproliferative disorders or blood cancers can result in the formation of abnormal blood cells. An important part of the spleen’s role is to remove such abnormal cells from circulation. In the process, the organ itself becomes affected.
  • Congestive splenomegaly: This can develop when the patient is suffering from conditions that obstruct normal blood circulation. This includes liver- and related disorders such as cirrhosis and portal hypertension. It can also develop in the event of blood clots in the splenic, hepatic or portal veins.
  • Infiltrative splenomegaly: This is normally associated with storage disorders or metabolic disorders like Gaucher disease and amyloidosis.

What Are Some Critical Consequences Of Hypersplenism?

Likely complications are discussed below:

  • Frequent infections: If there is a significant deficit of white blood cells, immunity becomes weak and the body is more susceptible to infections.
  • Splenic rupture: The abnormally enlarged spleen is vulnerable and can rupture. Hence, patients with this condition are advised not to unduly exert themselves and to avoid participating in activities such as contact sports.
  • Death of tissue: Normal blood supply may fail to keep up with the requirements of the enlarged organ. As a consequence, parts of spleen tissue may die off.

How Can It Be Diagnosed And Treated?

Hypersplenism removalIn a healthy individual, the spleen is a small organ that cannot be felt by palpating the abdomen.

However, if the spleen is significantly enlarged, it may be palpable. The patient may also have other typical signs of cytopenias such as anemia.

Pallor of skin and breathlessness indicate a shortage of red blood cells.

Frequent and recurring infections indicate a weak immunity. In order to resolve this problem, it is important to discover the underlying cause.

The patient may undergo the following procedures as part of diagnosis:

  • Physical examination.
  • Medical history.
  • Blood tests to check for signs of infections or metabolic disorders that may be responsible.
  • Urine tests can also indicate infections.
  • Ultrasound imaging.
  • Computerized tomography (CT).
  • Magnetic resonance imaging (MRI).
  • Liver function tests.
  • Tissue biopsy.

To treat hypersplenism, it is important to correctly diagnose the underlying condition. Upon treating the real cause behind hypersplenism, the symptoms can be reduced. This will also prevent further destruction of the RBCs and/or enlargement of the spleen. Splenic ablation (removal of spleen by surgery or radiation) is performed if no other method gives a positive result.

Facts

  • Hypersplenism is often associated with infections such as mononucleosis, endocarditis, and toxoplasmosis.
  • An enlarged spleen can compress the stomach as a result of which the patient feels full after eating less food and may complain of indigestion.

Facts

  • The major function of the human spleen is to remove old and damaged RBCs and purify the blood.

Facts

  • It is also followed by frequent hiccups due to irritation of the diaphragm.
  • 10% of patients of Lupus develop this condition.

Related Conditions

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Test Your Knowledge

Welcome to your Vital Organ Quiz

Which organ is responsible for filtering blood?
Cochlea is a part of which organ?
What percentage of the human body is water?
Which organ stores bile?
Humans can live without a spleen.
Which female organ produces eggs?
Which lung is wider?
Ganglia are a part of which system?
Which is the smallest organ in the human body?
Rod and cone cells are a part of which organ?

Take the full quiz
The most common symptom of hypersplenism is anemia. This is because an enlarged spleen causes widespread breakdown of RBCs. This can further cause fatigue and shortness of breath. Other symptoms of hypersplenism are- pain in the left abdomen, feeling of fullness in the said region, recurring (or frequent) infections, and general weakness. However, in many cases hypersplenism might not result in any noticeable symptoms at all.
Hypersplenism or enlarged spleen can occur due to a variety of reasons such as viral infections, metabolic disorders, trauma to the spleen, etc. It has been observed that a number of liver conditions can also cause hypersplenism. Liver cirrhosis, hepatitis C, portal hypertension - all of these liver diseases increase the risk for hypersplenism. Such conditions increase the blood pressure inside the spleen and thus increase the risk of an enlarged spleen.
If the spleen enlarges beyond a certain level, it can create pressure on the surrounding tissues and organs and turn painful. The pain of hypersplenism is often described as that of fullness and discomfort on the left part of the chest and abdomen. But in many cases, it might not be painful at all.
The human spleen is an organ completely dedicated to regulating immune responses within the body. When you catch malaria, the spleen generates immune signals to fight the disease-causing parasite. In case of frequent bouts of malaria over a long period of time, the spleen becomes massively over-worked and enlarged. This is also known as tropical splenomegaly syndrome.

 

Dos and Don'ts

Dos
  • Consume foods which are healthy for your liver, if liver inflammation is the cause for hypersplenism.
  • In case of splenectomy, the person’s immunity greatly reduces so it becomes important to keep up with regular vaccinations.
Don'ts
  • Readily opt for splenectomy, as this makes an individual more vulnerable to serious infections.
  • Stop antibiotic medication dosage abruptly. Complete the drug course.

 

 

 

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Dragon Fruit – Blessing from Nature’s Basket The dragon fruit is packed with nutrients and yet low on calories and is the dream food that…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
glutamine workout
Glutamine: Why is this the right choice for muscle-gain supplement? Glutamine can help you gain muscles and build higher immunity. Read more to find out how you can…
Moringa drink
Moringa: This could be the most nutrient-dense food known to us! Moringa is a lush green tree brimming with over 90 essential nutrients required for a healthy mind and…
Kava: Is it the healthy substitute for alcohol you have been waiting for? Native to the beautiful South Pacific islands, Kava is a famous beverage rooted in the local culture. It…
Is bronchitis contagious? And how to prevent this infection? It is acute bronchitis that is contagious which means you can contract it from another person or you…
Appendix pain: Recent findings on this not-so vestigial organ The exact function of the appendix is still not clear. Some consider it as an organ that once…
The Cabbage Soup Diet: The healthiest way to instant weight loss Cabbage soup diet rapid weight loss diet for those who want to shed those extra pounds in less…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
Barium-enema
Barium Enema Barium enema is also known as colon x-ray. Here, the patient is asked to consume small amount of…
Hysteroscopy_procedure
Hysteroscopy Hysteroscopy is a minimally invasive tool to help specialists view the uterus to diagnose and even treat several…
Thyroid disorders
Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
rosacea-treatment--before-_-after
The best and safest ways to treat rosacea Rosacea is a skin disease that is characterized by reddish hives and rashes on the face. Read more…