The importance of the liver for the functioning of the human body is probably understated. Besides the purification of blood and the production of bile, the liver performs other often overlooked vital functions. These include the activation of enzymes, storage of vitamins and minerals, synthesis of albumin, and metabolism activities. Due to this high work rate, the liver is exposed to many insults and there is a high risk of suffering injury if not careful. The Spleen is an organ which acts as a filter of blood. It recycles RBCs and stores platelets and WBCS. Both these organs are absolutely vital parts of the body.
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What is Hepatosplenomegaly?
With reference to the above situation, there is a condition where both the liver and spleen swell well beyond their normal size which is termed as Hepatosplenomegaly.
There are a number of causes which result in this condition. Enlarged liver and spleen can the major cause. Generally, any condition which affects the liver carries with it a probability of Hepatosplenomegaly. Enlargement of the liver can exert extra pressure on the spleen causing it to swell up. Thus anything causing hepatomegaly(enlargement of the liver) can result in splenomegaly(enlargement of the spleen), the combined condition is referred to as Hepatosplenomegaly.
Common causes include:
- Leukaemia – A cancer which results in an abnormal number of white blood cells. This affects the capability of the body to fend off infections.
- Acute Viral Hepatitis – This is the inflammation of the liver due to viral infection. Hepatitis A is the most common. The normal hepatitis infection is usually via food or water.
- Rubella – An infectious disease which forms distinct red rashes on the body. Rubella can be dangerous if it occurs during pregnancy and can cause severe harm to the unborn child. It can be prevented by vaccination.
- Cytomegalovirus – A common virus which once infected will be retained for life. A healthy person won’t be bothered much by this virus, however, for people with low immunity, it can be fatal.
- Brucellosis – A contagious disease caused by the bacteria Brucella. Brucellosis is considered as a significant health problem and can enter the body through a cut or by sexual contact.
- Typhoid – A bacterial infection which can result in a skin rash with rose color spots. People with typhoid experience high fever, headaches, and abdominal pain in the initial days.
- HIV – The HIV drugs can do direct damage to the liver cells. Lactic Acidosis, a condition caused by intake of HIV drugs can severely harm the liver by causing inflammation.
- Acromegaly – A hormonal disorder which affects the middle-aged adults. Acromegaly results in the pituitary gland producing excess growth hormone. This results in the lengthening of the bones in the face, hands, and feet.
- Obesity – Obesity increases the risk of fatty liver, which is a silent killer. Obesity is caused by excess food intake, lack of physical activity, and genetic factors.
- Thalassemia – This is a rare condition where the body produces an abnormal form of hemoglobin. Currently, there is no cure available, and the disease is an inherited one. There might be bone problems, enlarged spleen, and yellowish skin.
- Fatigue – Patients experience fatigue and tiredness
- Jaundice – The urine turns yellowish-brown along with the eyes and skin.
- The stool turns clay-brown in color.
- Constant itching throughout the body.
- Severe abdominal pain particularly in the upper-right region.
- The victims have reported higher stress level when affected by the condition.
- Swelling of the abdomen.
- A person with hepatosplenomegaly can feel the liver and spleen in their stomach. This is the defining symptom of the disease.
The spleen which usually weighs about 400g can weigh between 500 and 1000 g for a person with severe Hepatosplenomegaly. The symptoms vary from person to person and might be less severe in some cases.
The doctor will conduct a physical examination and examine the abdomen for any swelling. Also, diagnostic tests are performed which include
- Ultrasound scan for imaging. These help to determine if a tumor is causing the swelling.
- Blood tests including liver function tests.
- MRI Scan to confirm the diagnosis.
- In some cases, a Biopsy may be performed.
The treatment for the condition can vary from person to person depending on the underlying condition. Medications help to tackle many of the causes. Also, making changes to one’s lifestyle like following a healthy diet and reducing alcohol is a positive step. Physical exercise is highly beneficial as well.
In some cases, doctors may surgically remove a portion of the liver or spleen. In the most extreme cases, a liver transplant might be a necessity. If the underlying cause is cancer, then methods like chemotherapy would have to be used.
While Hepatosplenomegaly might not be a very serious disease, it might be a sign of something dangerous. The treatment varies from person to person and only in the most extreme cases, do we have to resort to methods like a liver transplant.