Hyperplenism: causes, symptoms, diagnosis, treatment

Hypersplenism is a syndrome of cytopenia caused by splenomegaly.

[1], [2], [3], [4], [5]

Causes of the hypersplenism

Hypersplenism is a secondary process that can be caused by splenomegaly caused by a variety of causes.

[6], [7]

Treatment of the hypersplenism

Treatment is aimed at the underlying disease. However, if hypersplenism is the single most serious manifestation of the disease (eg, Gaucher's disease), ablation of the spleen can be indicated by splenectomy or radiotherapy. Since the intact spleen has protective functions against infections with encapsulated bacteria, splenectomy should be avoided, if possible, and patients subjected to splenectomy should be vaccinated against infections caused by Streptociccus pneumoniae, Neisseria meningitidis, Haemophilus influenzae. After splenectomy, patients are especially sensitive to the development of severe sepsis, so when developing fever, such patients should be examined by a doctor with the appointment of empirical antibiotic therapy.

Indications for splenectomy or radiation therapy for hypersplenism

Indications	Example
Hemolytic syndrome, in which the shortened survival rate of erythrocytes with intracellular disorders is further reduced due to splenomegaly	Congenital spherocytosis, thalassemia
Pronounced pancytopenia against a background of massive splenomegaly	Lipid accumulation diseases (spleen size can be 30 times normal)
Vascular Stroke with Spleen Involvement	Recurrent infarcts, bleeding from varicose veins of the esophagus, associated with intensive venous return of the spleen
Mechanical trauma of other abdominal organs	Stomach with early saturation, left kidney with obstruction of calyces
Severe bleeding	Hyperplenic thrombocytopenia