Hematology

Hypersplenism

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Hypersplenism
portrait of Fernando Martínez Sáez
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Fernando Martínez Sáez
Medically reviewed by our Medical staff

Last update: 16-03-2022

How else can it be called?

  • Overactive spleen

  • CIE-9: 289.4

  • CIE-10: D73.1

What is hypersplenism?

Hypersplenism is a disorder where the spleen destroys rapidly and prematurely blood cells (red blood cells, white blood cells and platelets).

The spleen is an organ located in the upper left area of the abdomen with an important role in the immune response. One of its major functions is to store blood cells. Sometimes, the spleen can hold onto up to 90% of the body’s platelet and 45% of the red blood cells (RBCs). The spleen also removes any old or damaged blood cell from the body.

In case of suffering hypersplenism, the normal function of the spleen accelerates and it begins to remove functional blood cells.

What are the main causes?

Hypersplenism may occur as a primary disease (within the spleen itself) or secondary to other underlying disorder. The most common causes for secondary hypersplenism are:

Secondary hypersplenism is more common than primary hypersplenism.

What are the main symptoms of hypersplenism?

One of the most common symptoms of hypersplenism is splenomegaly (enlarged spleen) that may cause pain in the upper left side of the abdomen and a premature feeling of fullness at meals.

The difference between splenomegaly and hypersplenism is that splenomegaly refers only to an enlarged spleen and hypersplenism connotes an overactive function by the spleen.

Other common symptoms of hypersplenism are:

  • Fever
  • Weakness
  • Heart palpitations
  • Ulcers of the mouth, legs or feet
  • Unexplained bleeding from the nose

How can it be diagnosed?

The enlarged spleen can be noted or it may be seen with X-ray studies, such as ultrasound or computed tomography scan (CT scan).

In addition, when a blood count is performed, there may be a low count for Red Blood Cells (anemia), White Blood Cells (leukopenia) and platelets (thrombocytopenia).

What is the recommended treatment?

In case of secondary hypersplenism it is necessary to treat the underlying disease.

If the problem persists and the destruction of blood cells is severe, the splenectomy (removal of the spleen) must be considered.

The spleen is not an essential organ and it is possible to live without it. In case of splenectomy the functions of the spleen are taken over by other organs like the liver. However, the removal of the spleen has some risks because it increases the probability of suffering bacterial infections. For this reason, it is advisable to receive vaccination against pneumonia, influenza or meningitis.

Medically reviewed by our Medical staff on 16-03-2022

Bibliography

  • The Gale Encyclopedia of medicine. Second Edition. Jacqueline L. Longe. Vol 3. pag 1718. ISBN 0-7876-5492-2
  • Manual of Clinical and Practical Medicine. G.S. Sainani, V.R. Joshi and Rajesh G. Sainani. Pag 265. ISBN 978-81-312-2313-0

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