Hypersplenism

Hypersplenism spleen

Last Updated December 20th, 2021

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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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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Thyroid Profile Thyroid profile is a panel of blood tests performed to check if an individual is suffering from any…
woman with abdominal pain holding ovulation calendar
Ovulation – facts to know about ovulation Learn how and when ovulation occurs, demystify common misconceptions, identify symptoms, methods of detection and right period for…
hidden benefits walking
9 benefits of walking we bet you didn’t know! Did you know walking can be the miracle pill for eternal youth? Everyone knows walking is good for…
dance health benefits
5 unbelievable effects of dance on your overall health! You enjoy dancing, but did you know what else it does to your body? Dancing is not only…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
dandelion health benefits
Dandelion: Little parachutes of health and wellness for your whole body Dandelions are not just bright looking blossoms that cheer your mind. These are powerpacked with essential nutrients that…
Jackfruit: Slice your way into higher immunity, better digestion, & more… Native to the South East Asia, the jackfruit is a fruit brimming with thousands of health benefits. Discover…
Juice Plus: Can you really replace actual fruits with pills?  Juice Plus supplements intend to fill nutritional gaps present in our daily diet. But how successful have they…
dandelion weight loss
Caralluma Fimbriata: How to eat this cactus to lose weight Caralluma fimbriata is a miracle cactus that can be safely consumed by most for losing weight and boosting…
Love tea, hate tannins? Rooibos tea is just what you need The market is brimming with a multitude of herbal teas. But what makes rooibos tea (or red bush)…
What to eat, what not to eat in the South Beach Diet? The South Beach Diet is one among the most popular weight loss programs that have been the talk…
Vagus nerve: 7 health benefits of stimulating the “gut-brain” connection As a matter of fact, there are two vagus nerves namely the left and the right but is…
ANTIPHOSPHOLIPIDANTIBODY(APL)_IgG
Antiphospholipid (APL) antibody-IgG The Antiphospholipid Antibody testing is a blood test used to determine an autoimmune disorder called Antiphospholipid syndrome linked…
fructosamine test
Fructosamine Test A fructosamine test measures blood sugar glucose content. Fructosamine level can indicate blood sugar level in past 2-3…
Okra: How can this nutrient-dense vegetable help you fight diabetes? Okra is a food which is rich in nutrients and minerals which are extremely essential for a healthy…
hidden causes obesity
8 hidden causes of obesity you probably didn’t know! Did you know that around 2 billion people worldwide are either overweight or obese? Are you too a…
Jicama: A fiber-rich tuber for your weight loss goals Pronouced as HEE-kah-ma, Jicama is the "new kid on the block" that has taken the world by the…
Tart Cherry: The healthiest excuse for taking that second serving of pie Tart cherry has been traditionally used in delectable desserts such as pies. Recent studies have revealed that its…
Piaget stages: Do they accurately describe the way the human brain develops?  A common assumption was that children are less competent thinkers as compared to adults, but this was refuted…
Ear pain model
Easy and safe tips for ear wax removal you can do at home Cerumen impaction generally occurs when an external object like cotton swabs are used to remove the ear wax.…
Balneotherapy jacuzzi
5 things you didn’t know about balneotherapy and how you can do it at home Sauna baths have been popular since a long time. But how much more beneficial can balneotherapy be as…
Chest X-Ray A chest x-ray is a diagnostic test that uses x-rays to visualize the structures inside your chest. It…
valproic acid test
Valproic Acid Test Valproic acid test is performed to generally check for psychiatric and even neurological conditions such as bipolar disease…
PROGESTERONE_test
Progesterone test The progesterone test is a blood test used to determine the level of hormone progesterone in the blood…
phenytoin test
Phenytoin test Phenytoin is a drug that is administered mainly to epilepsy patients. The phenytoin blood test measures the level…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
Optavia diet
The features of an Optavia diet The Optavia diet endorses pre-packaged meals and snacks called "fuelings" that are tasty, low in calorie, and incorporates…
alcohol toxic
7 startling facts that will make you quit alcohol today Does drinking really make you friendly and happy? How many calories does a can of cold beer add…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
Agave nectar: The bitter truth about this sweetener revealed Agave nectar is considered to be sweeter than the normal table sugar and even contains higher amounts of…
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…
Plexus Slim: Is this pink slimming drink the ultimate one-stop fat burner? How effective is Plexus Slim in helping people lose weight? What are its ingredients? Can it be safely…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
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…
Top reasons why you need to pay attention to your vitamin B6 intake Vitamin B6- An essential water-soluble vitamin. Its deficiency leads to physical changes such as sores & glossy tongue…
These are the top foods to increase your hemoglobin count It is important to add iron-rich foods into your diet in order to increase hemoglobin. Deficiency of hemoglobin could…
myelogram
Myelography Myelography is an important diagnostic tool that is used to investigate and identify abnormalities in the spine and…
antihepatitis core antigent
Anti-Hepatitis B Core Antigen (AHBc) Total Anti-hepatitis B core antigen (AHBC ) is a blood examination and the only serological marker of infectious blood…
sodium blood test
Blood Sodium Test A blood sodium test measures the amount of sodium (an important electrolyte) in your body. It is also…
carrageenan seaweed
Carrageenan: How a simple seaweed extract could better your gut health & immunity Eat more ice cream to prevent cold and flu? –With carrageenan you get one simple seaweed extract that…
lose weight fast
12 easy and instant steps to successful weight loss Do you want to lose weight without losing your mind? Does weight loss always mean saying goodbye to…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…
aspartame or sugar
Aspartame – Hidden truths about this storm in a teacup Aspartame, the artificial sweetener, has gone under the scanner on several occasions for allegedly doing more harm than…
50 common health conditions
What are the top 50 deadly and widespread diseases? A complete list of the top 50 most common and deadly diseases that plague humanity. Which disease is…
High Fiber Diet – Fire up your fiber intake for these health benefits! Regular bowels, healthy detox, higher immunity, and guaranteed weight loss - a high fiber diet can bring all…