Alerts and Notices
SynopsisHypersplenism is the enlargement of the spleen and is usually a symptom of an underlying condition. Common signs and symptoms may include left upper quadrant tenderness and/or pain, abdominal discomfort, feeling of fullness, and splenomegaly on physical examination. Laboratory abnormalities (although nonspecific) such as thrombocytopenia, neutropenia, and/or anemia suggest the presence of an enlarged spleen.
The spleen sequesters about one-third of blood platelets under normal circumstances, but with splenic enlargement, platelet sequestration may be as high as 90%. Splenic enlargement can occur at any age and can be transient (eg, underlying infection) or progressive.
Treatment involves managing the underlying condition leading to splenic enlargement, as splenectomy is rarely curative and should be reserved for select patients.
D73.1 – Hypersplenism
58381000 – Hypersplenism
Differential Diagnosis & Pitfalls
- Drug-induced hemolysis (eg, antibiotics, NSAIDs, antimalarials)
- Splenic vein thrombosis
- Myeloproliferative disease
- Paroxysmal nocturnal hemoglobinuria
- Microangiopathic hemolytic anemia
- Thalassemia (alpha, beta)
- Myelodysplastic syndrome
- Infection (eg, malaria, mononucleosis, AIDS)
- Portal hypertension
- Thrombotic thrombocytopenic purpura / hemolytic uremic syndrome
- Idiopathic thrombocytopenic purpura
- Hereditary spherocytosis and other RBC membrane defects