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Enlarged spleen: Causes, symptoms and treatments

Enlarged spleen, also called hypersplenism or splenomegaly, happens when the spleen grows in size because of infection or other medical conditions, including blood disorders.

The spleen sits under your rib cage in the upper left part of your abdomen toward your back. It is an organ that is part of the lymph system and works as a drainage network that defends your body against infection.

White blood cells produced in the spleen engulf bacteria, dead tissue, and foreign matter, removing them from the blood as blood passes through it. The spleen also maintains healthy red and white blood cells and platelets; platelets help your blood clot. The spleen filters blood, removing abnormal blood cells from the bloodstream.

A spleen is normally about the size of a fist. A doctor usually can't feel it during an examination, but diseases can cause it to swell and become many times its normal size. Because the spleen is involved in many functions, many conditions may affect it.

An enlarged spleen is not always a sign of a problem. When a spleen becomes enlarged, though, it often means it has been doing its job but has become overactive. For example, sometimes the spleen is overactive in removing and destroying blood cells. It can happen for many reasons, including problems with too many platelets and other disorders of the blood.

Causes of an enlarged spleen

An enlarged spleen can be caused by infections, cirrhosis and other liver diseases, blood diseases characterised by abnormal blood cells, problems with the lymph system or other conditions.

Here are some common causes of an enlarged spleen:

Infections

  • Viral infections, such as mononucleosis
  • Parasitic infections, such as toxoplasmosis
  • Bacterial infections, such as endocarditis (an infection of your heart's valves)

Cancer

  • Leukaemia, a cancer in which white blood cells displace normal blood cells
  • Lymphoma, a cancer of lymph tissue, such as Hodgkin's disease

Other causes of an enlarged spleen include:

  • Inflammatory diseases such as sarcoidosis and rheumatoid arthritis
  • Trauma, such as an injury during contact sport
  • Cancer that has spread or metastasised to the spleen
  • A cyst, a noncancerous fluid-filled sac
  • A large abscess, a pus-filled cavity usually caused by a bacterial infection
  • Infiltrative diseases such as Gaucher's disease, amyloidosis, or glycogen storage diseases
  • Thalassaemia blood disorder

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