Splenic diseases

Disease class: Lymphatic diseases

Organ: The spleen

Types

• Heterotaxy syndrome
• Hypersplenism
• Splenic infarction
• Splenic neoplasms
• Splenic rupture
• tuberculosis, Splenic
• Wandering spleen 

 

Splenomegaly 

The spleen can become enlarged. It may predispose to a rupture of the spleen, so these patients should be advised against contact sports etc.

•  It can be a consequence of a problem with systemic circulation. The most well-known examples would be congestive heart failure and portal hypertension. If blood flow through the liver is reduced due to cirrhosis, the liver cannot accept blood through the hepatic portal vein at a sufficient rate and consequently the vessels become congested with blood (portal hypertension). As this backlog of fluid builds, the spleen cannot drain fast enough and becomes bloated with blood.
• It can be an immune response to certain infections. Perhaps the most famous would be infectious mononucleosis (also called mono, glandular fever, etc.) 
• Splenomegaly is one of the features of hypersplenism.
• It can be a sign of infiltration by haematological malignancies (leukaemias, lymphomas, etc.).

 

Asplenia 

• The spleen can be removed from a human (splenectomy). This surgery is performed to treat various diseases.
• Some people are born without a spleen (congenital asplenia). 
• Some diseases gradually destroy the spleen, e.g. sickle cell disease. This is called autosplenectomy. 

Asplenia does not usually have a large impact on a patient's life. However, there are some consequences to lacking a spleen. These patients have a reduced rate of successful response to vaccination. They have reduced levels of serum IgM. They have an increased incidence of serious infections by encapsulated bacteria, e.g. Streptococcus pneumoniae. This explains the emergencies known as overwhelming post-splenectomy infection (OPSI) and sepsis (OPSS).