Enlarged spleen – causes
Any palpable spleen is considered to be pathological. Splenomegaly may take different aspects in terms of size, from a discreet enlarged spleen to a spleen that can handle the entire abdomen.
As mentioned above, the spleen can be assessed clinically by palpation of the abdomen and with a series of laboratory investigations as ultrasound or splenic scintigraphy with Crom51.
Splenomegaly may be accompanied by hypersplenism translated as cytopenia (quantitative reduction of cell lines), anemia can occur (due to decreased number of erythrocytes and thus the amount of hemoglobin), leukopenia (low white blood cell count) and thrombocytopenia (low platelet count).
Splenomegaly causes are varied, so it can be:
Other conditions that can accompanied by splenomegaly are hemolytic syndromes and tesaurismosis (group of disorders characterized by abnormal storage in some tissues or organs of lipids, carbohydrates or proteins).
Inflammatory splenomegaly appears in bacterial, viral, parasitic, tuberculosis, collagen disease and syphilis.
Spenomegaly can have different characters depending on condition.
Thus, in bacterial infections, pyogenic septicemia is accompanied by a moderately increased spleen, soft, slightly sensitive to touch, in typhoid and paratyphoid the splenomegaly is accompanied by fever, digestive phenomena, positive blood cultures .
Of viral infection accompanied by splenomegaly, infectious mononucleosis is clinically characterized by angina (acute inflammation of the neck isthmus and throat, including tonsils), multiple lymphadenopathy (enlarged lymph nodes) and splenomegaly.
In tuberculosis, the spleen is bulky and is accompanied by adenopathy and hepatomegaly (liver size increased).
The following parasitic diseases may be accompanied by splenomegaly: malaria, toxoplasmosis, leishmaniasis, splenic hydatid cyst.
Collagen diseases which have as a clinical sign the splenomegaly are represented by lupus erythematosus, Felty syndrome, Still’s disease.
Congestive splenomegaly appear in portal hypertension syndrome of various types of liver cirrhosis, in portal vein thrombosis, splenic vein compression (tumors, pancreatic cysts, lymph nodes), Budd-Chiari syndrome.
Proliferative splenomegaly occurs both in systematized proliferative processes as chronic lymphatic leukemia, chronic myeloid leukemia, Hodgkin’s disease, multiple myeloma, Waldenstrom’s macroglobulinemia and in splenic tumors (hydatid cyst, cyst bleeding, vascular tumors, sarcomas of spleen).
Hemolytic diseases as Minkowski-Chauffard disease is clinically characterized by jaundice (yellowing of the skin and mucous membranes), anemia and splenomegaly. Other conditions, characterized by hemolysis and have as clinical sign the splenomegaly are thalassemia, sickle-cell anemia, Eliptocitosis.
Tesaurismosis accompanied by splenomegaly are Gaucher disease (enlarged spleen and liver, tan and yellow skin, bone pain and fractures), Hand-Schuller-Christian disease (splenomegaly, high cholesterol, changes in bone) and amyloidosis.