From WikiLectures

Splenomegaly is an enlargement of the spleen over it's normal size. The size of the spleen can be variable: normal adult spleen is about 10-13 cm long and 6-8 cm wide.

Splenomegaly in adult due to CLL

Classification[edit | edit source]

Adult classification
  1. mild splenomegaly – weight of the spleen is up to 500 g, examples: acute bacterial infection, chronic venous stasis, infectious mononucleosis
  2. moderate splenomegaly – weight of the spleen is between 500 and 1000 g, examples: steatosis, amyloidosis, chronic bacterial infections, autoimmune hemolytic anemia
  3. severe splenomegaly – weight of the spleen is over 1000 g, examples: hemolytic anemia, primary tumors of the spleen, chronic myeloid leukemia.

Hypersplenism is defined as an increased activity of the spleen which can lead to the splenomegaly. Complications of having splenomegaly is a ruptured spleen which is often an indication for splenectomy, in this case the spleen's function is taken over by the liver and the bone marrow.

Causes[edit | edit source]

The main causes of the splenomegaly are[1] [2]:

  • infection : in children it can be caused by any types of infectious illnesses (reaction to an antigenic stimulus)
    • bacterial infections
    • mainly EBV [1] and CMV infections
    • parasite infections, for example malaria [1], leishmaniasis
  • cardiovascular diseases[2]:
    • right-sided heart failure,
    • thrombosis of the portal vein system and a. lienalis (for example due to the pancreatic cancer)[2],
    • endocarditis
    • portal hypertension[1] (in adulthood commonly due to the liver cirrhosis[2]);
  • hemolysis[1] and increased elimination of the erythrocytes:
    • Intracorpuscular hemolytic anemia: early thalassemia [1], spherocytosis, sickle cell anemia[1]
    • Extracorpuscular hemolytic anemia
  • Tumors:
    • myeloproliferative disorders: chronic myeloid leukemia, extramedullary hematopoiesis due to the primary myelofibrosis,
    • lymphoproliferative disorders: hairy cells leukemia, splenic lymphoma
    • metastasis to the spleen
  • autoimmune diseases[2]:
  • amyloidosis
  • storage disorders, mainly lysosomal[1]: mucopolysaccharidosis type I, II and VII; Gaucher disease, Niemann-Pick disease, generalized gangliosidosis, Wolman's disease

Links[edit | edit source]

Related Articles [ modify | edit source ][edit | edit source]

  • Spleen • Spleen disease • Splenomegaly • Hepatosplenomegaly • Spleen injury
  • Diagnostic imaging methods in the examination of the pancreas, liver and spleen
  • Development of lymphatic vessels, nodes and spleen
  • Spleen (specimen) • Secondary amyloidosis of spleen (specimen) • Spleen / Spleen - Ag • Spleen / Spleen - Pearls • Spleen (SFLT)

References[edit | edit source]

  1. a b c d e f g h MARCDANTE, Karen J – KLIEGMAN, Robert M – JENSON, Richard E. Nelson essentials of pediatrics. 6. edition. Philadelphia : Saunders/Elsevier, 2011. 831 pp. Chapter 206–207, 561. ISBN 978-1-4377-0643-7.
  2. a b c d e KOUBA, Michal. Stáž v ÚHKT [lecture for subject Interna předstátnicová stáž, specialization Všeobecné lékařství, 1. lékařská fakulta Univerzita Karlova]. Praha. 27.5.2014.