From the Guidelines
Splenomegaly, or enlarged spleen, is most commonly caused by infections, hematologic disorders, liver diseases, inflammatory and autoimmune conditions, and storage diseases, as evidenced by recent studies 1. The causes of splenomegaly can be categorized by underlying mechanisms, including:
- Infections, such as bacterial infections like endocarditis and tuberculosis, viral infections like mononucleosis (EBV), HIV, and CMV, and parasitic infections like malaria and leishmaniasis
- Hematologic disorders, including hemolytic anemias, leukemias, lymphomas, myeloproliferative disorders, and hemoglobinopathies like sickle cell disease and thalassemia
- Liver diseases causing portal hypertension, such as cirrhosis and portal vein thrombosis, which can result in congestive splenomegaly
- Inflammatory and autoimmune conditions, like rheumatoid arthritis, systemic lupus erythematosus, and sarcoidosis, which may also cause splenic enlargement
- Storage diseases, including Gaucher's disease and Niemann-Pick disease, which lead to splenomegaly due to accumulation of substances in the spleen The spleen enlarges because of its role in filtering blood and immune function - when these functions are stressed by infection, inflammation, or cellular abnormalities, the spleen can hypertrophy or become congested with blood or abnormal cells. Diagnosis typically requires identifying the underlying cause through history, physical examination, laboratory tests, and imaging studies, as recommended by recent guidelines 1. It is essential to note that the management of splenomegaly depends on the underlying cause, and treatment may involve addressing the underlying condition, as well as managing symptoms and preventing complications, as discussed in recent studies 1.
From the Research
Causes of Splenomegaly
The causes of splenomegaly can be diverse and are often associated with systemic conditions. Some of the common causes include:
- Liver disease, which is one of the most common causes of splenomegaly in the United States 2
- Malignancy, such as leukemia or lymphoma 2, 3
- Infection, including infectious mononucleosis, malaria, and schistosomiasis 2, 3
- Hematologic disorders, such as anemia or thrombocytopenia 4, 3
- Congestive or inflammatory disorders, such as congestive heart failure or thyrotoxicosis 3
Systemic Conditions Associated with Splenomegaly
Splenomegaly can be associated with various systemic conditions, including:
- Hepatic diseases, such as chronic liver disease or cirrhosis 4, 3
- Infectious diseases, such as tuberculosis or endocarditis 3
- Hematologic diseases, such as leukemia or lymphoma 3
- Congestive heart failure, which can cause splenomegaly due to increased venous pressure 3
Pathophysiological Bases of Splenomegaly
The pathophysiological bases of splenomegaly involve the spleen's ability to expand in response to various pathological conditions, including stress, infection, or chronic disease 5. The spleen's normal function and physiology can be disrupted, leading to splenomegaly, which can be detrimental to the individual's wellbeing 5.