From the Research
Concerns with Severe Splenomegaly (Grade 4 Spleen)
- Severe splenomegaly, also known as Grade 4 spleen, can lead to various complications, including hypersplenism, which may cause thrombocytopenia and contribute to portal hypertension-related bleeding 1.
- Patients with severe splenomegaly are at risk of developing splenic rupture, which can be catastrophic 2, 3.
- Splenomegaly can also increase the risk of splenic artery aneurysms, which are the most common visceral artery aneurysms in humans and can rupture with significant clinical sequelae 1.
- Severe splenomegaly may require hemostatic interventions, such as transarterial embolization, and can impact the treatment strategy for blunt splenic injury in adults 3.
- Splenectomy for massive splenomegaly (spleen weight more than 1.5 kg) can be safe and provide effective palliation, with relief of pressure-volume-related symptoms and sustainable independence from transfusion in patients 4.
Complications and Management
- Acute infections, anemia, and splenic rupture are common complications of splenomegaly, and patients with limited splenic function require increased vaccination and prophylactic antibiotics for procedures involving the respiratory tract 2.
- Management of splenomegaly involves treating the underlying disease process, and splenectomies and spleen reduction therapies may be performed in some cases 2, 4.
- Experimental systems are being used to determine the regulatory mechanisms underlying splenomegaly, and new therapeutic options are being explored 5.