Hypersplenism is a condition that may occur in association with splenomegaly. In doing so, the spleen enlarges, increasing its functional effects more than necessary and causing difficulties.
What is hypersplenism?
As the spleen enlarges, more blood cells are released from the organ. These are primarily erythrocytes, leukocytes and thrombocytes. See AbbreviationFinder for abbreviations related to Hypersplenism.
Basically, the term hypersplenism describes an overactive function of the spleen. The synonymous term hypersplenia is sometimes used for the disease. In the majority of cases, hypersplenism develops as a result of an enlargement of the spleen.
This disease is called a complication of splenomegaly. In connection with the enlargement of the organ, its capacity is significantly increased. This causes a larger number of blood cells to accumulate inside the spleen.
In addition, more blood cells are released from the organ. As a result, the blood cells decrease, which is also known as pancytopenia. The different types of blood cells such as leukocytes, erythrocytes and thrombocytes are involved to varying degrees. The organism tries to compensate for the pathological condition by increasing the bone marrow.
Causes
There are several causes for the development of hypersplenism. As a rule, certain underlying diseases are responsible for the formation of hypersplenism. Very often, these are blood-related diseases, rheumatoid arthritis or high pressure in the portal veins.
A basic distinction is made between primary and secondary hypersplenism. A primary hypersplenism is, for example, in connection with the so-called Banti disease. Secondary hypersplenism is possible in several diseases implying enlargement of the spleen.
In addition, various infections can be considered as causes, such as malaria, kala azar or Felty syndrome. In addition, some malignant lymphomas, cirrhosis of the liver or various autoimmune diseases such as erythematosus lead to the formation of hypersplenism. In addition, various storage diseases, such as Gaucher syndrome or thesaurismoses, are able to trigger hypersplenism.
In principle, there is no other underlying disease in primary hypersplenism. Secondary causes are, for example, diseases of the gallbladder or liver such as viral hepatitis or cholangitis. Hematogenous causes exist, for example, in hemolytic anemias, leukemias or Hodgkin’s disease.
Possible storage diseases are hemochromatosis or glycogenoses. Infectious diseases that may cause hypersplenism include AIDS, typhoid, mononucleosis, and leptospirosis. Toxoplasmosis, Bang’s disease, rubella and paratyphoid are also included.
Symptoms, Ailments & Signs
Hypersplenism is accompanied by a number of typical symptoms and complaints. As the spleen enlarges, more blood cells are released from the organ. These are primarily erythrocytes, leukocytes and thrombocytes.
Pancytopenia, a so-called cell deficiency, develops as a result. Different types of blood cells are involved to varying degrees. If anemia develops, frequent blood transfusions may be necessary. Thrombocytopenia increases the tendency to bleed, while leukocytopenia makes the affected patient more susceptible to infectious diseases.
As a reaction to the enlargement of the spleen, the bone marrow, which is responsible for blood formation, hypertrophies. If the spleen is particularly enlarged, it may lead to pain because neighboring organs are squeezed. General symptoms of hypersplenism include dry mucous membranes, signs of anemia, or an unusually strong craving for sweet foods.
With a slight enlargement of the spleen, symptoms of endocarditis or typhoid fever are possible. A medium enlargement manifests itself, for example, in leukemia, hepatitis or cirrhosis of the liver. If the spleen is particularly enlarged, the affected patients sometimes suffer from a feeling of pressure in the upper abdominal area on the left side of the body.
In principle, the functions of the spleen increase according to the degree of its enlargement. The consequences are cytopenia, anemia or thrombocytopenia. Bone marrow hyperplasia is also possible.
Diagnosis & course of disease
If a person suffers from one or more typical symptoms of hypersplenism, a doctor should be consulted. In the first step of the examination, the doctor treating you analyzes the patient’s medical history. Following the anamnesis, various clinical examinations are carried out. For example, the spleen, which is significantly enlarged in hypersplenism, is palpated.
During an ultrasound examination, the enlargement of the spleen is clearly evident and indicates the disease. The suspicion of the diagnosis of hypersplenism is confirmed by a blood test. This shows the reduced proportion of blood cells. Laboratory tests also show increased bone marrow. A reliable diagnosis can be made by scintigraphy.
Complications
In most cases, hypersplenism leads to enlargement of the spleen. This causes severe pain for the patient. If hypersplenism is not treated, various symptoms can develop over time. As a rule, the patient is more susceptible to infections and inflammations and thus becomes ill more often. The person concerned feels weak and exhausted and no longer actively participates in life.
The enlargement of the spleen can also displace or squeeze other organs, leading to complications in the affected organs. As the disease progresses, cirrhosis of the liver and, in the worst case, leukemia develop. The person affected also suffers from unpleasant feelings of pressure on the left side of the body, which makes everyday life difficult for the person concerned and severely restricts the quality of life. In the worst case, if left untreated, the patient may die.
In many cases, with hypersplenism, the spleen is completely removed from the patient’s body. Since this organ is not vital, no further complications arise. In many cases, however, the symptoms can also be reduced with the help of blood transfusions, so that no surgical intervention is necessary.
When should you go to the doctor?
A doctor should be consulted if the face is noticeably pale, if there is inner weakness or exhaustion. Severe bleeding from minor injuries is considered unusual and must be controlled. Due to the existing anemia, the affected person is threatened with an undersupply of the organism and thus a life-threatening condition. Dizziness, unsteady gait, weakness and loss of energy are indications that should be examined. If the person concerned suffers frequently from infections or is prone to inflammation, a check-up visit is advisable to clarify the indications.
Pain, difficult breathing or tightness in the upper body must be examined and treated. Dry mouth, dry mucous membranes or swallowing difficulties must also be medically clarified. If the person concerned feels the need to eat more sweet foods, this is considered unusual. A doctor should be consulted if this craving for sweet foods persists for several weeks or months.
If you experience headaches, increased heart palpitations or reduced mental performance, it is advisable to consult a doctor. A doctor is required in the case of reduced physical strength and increased tiredness. Lack of drive, withdrawal behavior and a melancholic mood are indications that should be followed up. If there is a disturbance in attention or gait insecurity, a doctor’s visit is advisable.
Treatment & Therapy
There are various options for treating hypersplenism. On the one hand, regular blood transfusions are an option to compensate for the lack of blood cells. This is particularly the case with anemia or thrombocytopenia.
In principle, however, the spleen is not an organ that is absolutely necessary for the viability of the human organism. For this reason, the removal of the spleen (medical term splenectomy) is recommended in the case of serious problems.
Outlook & Forecast
The overactive spleen can have various causes. These are decisive for the prognosis of hypersplenism. If the complication occurs as a result of cancer, the prognosis is made depending on the prospect of a cure, the time of diagnosis, the general state of health of the patient and the effectiveness of the therapy. With successful cancer therapy and the completion of all follow-up treatments, the hypersplenism can regress completely.
If the cancer has progressed so far that a cure can no longer be achieved, the treatment plan is restructured. The aim is then to alleviate the symptoms of serious impairments and not to heal the hypersplenism.
In the case of a chronic underlying disease, regression of the enlarged organ is not indicated. In a long-term therapy, the organism is regularly supported with the necessary blood cells. Permanent regeneration of the spleen is rarely achieved, if at all. If the treatment plan includes removal of the spleen, all symptoms associated with hypersplenism will spontaneously resolve.
The non-vital organ can be removed from the patient in a routine procedure in the event of severe pain or if there is no hope of alleviating the symptoms in an operation. Since a surgical procedure is always associated with risks and side effects, it can lead to sequelae or complications.
Prevention
Concrete methods and measures for the effective prevention of hypersplenism are currently not yet known or have not been adequately researched. It is all the more relevant to consult a suitable doctor at the first sign of hypersplenism and have the symptoms examined. Early diagnosis has a positive effect on the prognosis.
Aftercare
Follow-up treatment for hypersplenism depends on the severity of the disease and whether the spleen was surgically removed. In general, the disease cannot be prevented by one’s own preventive measures. Medical therapy is therefore essential for patients.
When it comes to follow-up care, it is important to recognize early signs of a relapse immediately and to examine them during a medical appointment. The sooner the diagnosis is made, the better the prognosis for those affected. Patients should also take it easy during the aftercare phase. Physically strenuous activities and stress represent a high burden and can have a negative impact on health.
In general, patients receive regular blood transfusions. A consistent appointment is very important here. In connection with anemia in particular, doctors recommend close monitoring to identify any deficiency symptoms or other symptoms in good time. There are special dietary supplements to counteract the typical deficiency symptoms in patients.
The attending doctor can estimate which products are suitable for the individual case and how high these should be dosed. Therefore, the intake of such funds should be done in close consultation with the doctor.
You can do that yourself
As a rule, hypersplenism cannot be treated by means of self-help. Those affected are dependent on medical treatment in any case, so that there is no reduced life expectancy.
With this disease, it is important for patients to take it easy and not expose themselves to strenuous activities or unnecessary stress. Since the symptoms can only be treated by regular blood transfusions, care should be taken to ensure that they are carried out regularly. Regular check-ups are necessary, especially in the case of anemia. Since some of those affected also suffer from deficiency symptoms, dietary supplements can be taken. However, the type and amount of these funds should always be discussed with a doctor first.
In severe cases of hypersplenism, those affected have to have the spleen removed. To avoid complications from this disease, a doctor should be consulted at the first sign. The contact and exchange of information with other patients often has a very positive effect on the course of the disease. Talking to family members or friends is very helpful in the case of psychological problems. In serious cases, a psychologist can also provide help.
