Hepatosplenomegaly is a medical condition in which both the liver and spleen are enlarged. A health care professional can make a hepatosplenomegaly diagnosis during a clinical examination. Common causes include the presence of certain other medical problems, such as mononucleosis, hepatitis, and some types of genetic disorders. Prescribed treatments depend on the specific diagnosis.
Symptoms
The most common symptom of hepatosplenomegaly is pain in the upper right abdomen. There may also be noticeable swelling, particularly on the right side of the abdomen, as well as tremors and a fever. Many people with this condition have gastrointestinal problems like a stomach ache, nausea, vomiting, diarrhea, and changes in urine and stool color. As the condition progresses, they may also develop jaundice, which is a yellowing of the skin and eyes. In addition to these symptoms, people with this condition usually have symptoms related to the underlying disease or disorder that's causing the swelling.
Causes
Common causes of hepatosplenomegaly are mononucleosis, hepatitis, and Lysosomal Storage Disorders (LSDs). Mononucleosis spreads through saliva and mucus, and may cause a high fever, enlarged lymph nodes, and a severe sore throat. Patients diagnosed with mononucleosis are most often between the ages of 15 and 17, and most of them make full recoveries after the virus runs its course. Antibiotics generally do not work in treating this kind of virus, although some health care specialists may prescribe corticosteroid medications to help relieve throat swelling.
Another common cause of this condition is acute viral hepatitis. In addition to an enlarged liver and spleen, patients with acute viral hepatitis may also experience poor appetite, fever, and jaundice of the skin or whites of the eyes. Recovery can take up to eight weeks, and treatment normally entails several courses of antiviral medications.
LSDs, a group of about 50 rare genetic conditions, can also cause swelling of the liver and spleen. The most common LSDs are Gaucher's, Niemann-Pick, and Tay-Sachs diseases. Each one is usually diagnosed in early childhood and can cause death shortly thereafter. There is no cure for LSDs, but treatment with bone marrow transplantation and enzyme replacement therapy may alleviate certain symptoms.
Other causes of hepatosplenomegaly may include tuberculosis, malaria, and some forms of cancer. Some auto-immune disorders can also lead to this condition, including Systemic Lupus Erythematosis (SLE) and juvenile rheumatoid arthritis. Parasitic infections, chronic alcoholism, and cat scratch fever are also associated with liver and spleen swelling.
Diagnosis
Hepatosplenomegaly is usually diagnosed with an ultrasound or a Computed Tomography (CT) scan of the abdomen. If a healthcare provider suspects that a person has a disease that affects the liver and spleen, he or she will usually order tests for that condition as well. For instance, if a person comes in with jaundice and complaining of abdominal pain, the healthcare provider would test him or her for hepatitis as well as doing a scan of the abdomen.
Treatment
The treatment for hepatosplenomegaly largely depends on the underlying cause. Most of the time, when that is treated, the swelling goes down naturally. In those with conditions that can't be cured, treatment focuses on managing the symptoms and improving the liver and spleen's function. This includes things like enzyme replacement therapy, which can help keep the size of the liver and spleen down, and avoiding things that stress the liver, like drinking alcohol or taking Non-Steroidal Anti-Inflammatory Drugs (NSAIDs).
Complications
There are a number of complications associated with this condition, including liver failure. If this happens, a person may become confused, go into a coma, or die. Hepatosplenomegaly can also lead to a ruptured spleen, which can cause serious internal bleeding and death.