What is this Condition?
In this condition, the spleen aggressively filters the blood and removes any blood cells that are abnormal, aging, or coated with antibodies, even though some may be functionally normal. The overÂactive spleen may also temporarily withhold normal red blood cells and platelets from the circulation.
What Causes it?
An enlarged spleen may have no apparent cause or it may result from another disorder, such as chronic malaria, an abnormal increase in the red blood cell count, or rheumatoid arthritis.
What are its Symptoms?
Most people with an enlarged spleen have anemia (decreased hemoglobin) or too few circulating white blood cells or platelets. This causes frequent bacterial infections; easy bruising; spontaneous bleeding from the mucous membranes and the digestive or urinary tract; and sores of the mouth, legs, and feet. Fever, weakness, and palpitations are other common symptoms.
How is it Diagnosed?
To diagnose the condition, the doctor must find evidence of an enlarged spleen and must determine that the spleen is destroying or trapping red blood cells or platelets.
In the most definitive diagnostic test, the person receives an intravenous infusion of red blood cells or platelets labeled with radioactive chromium; then red blood cells in the spleen and liver are measured.
The doctor also orders a complete blood count, which typically shows decreased hemoglobin, white blood cells, platelets, and immature red blood cells. A spleen scan, spleen biopsy (removal and analysis of tissue), and X-ray studies of the spleen’s blood vessels may be useful. However, a biopsy is hazardous and should be avoided if possible.
How is it Treated?
If the person doesn’t respond to medical therapy and must depend on transfusions, all or part of the spleen is removed. Although spleen removal rarely cures the disorder, it does correct the effects of low blood cell counts. Postoperative complications may include infection and blocked blood vessels.
If spleen enlargement results from an underlying disorder, that disorder must be treated.