Hepatosplenomegaly is when both the liver and spleen are enlarged, often caused by underlying medical conditions such as mononucleosis, hepatitis, and genetic disorders. Symptoms include abdominal pain, swelling, and gastrointestinal issues. Diagnosis is made through imaging and treatment depends on the specific cause. Complications can include liver failure and ruptured spleen.
Hepatosplenomegaly is a medical condition in which both the liver and spleen are enlarged. A healthcare professional can make a diagnosis of hepatosplenomegaly during a clinical exam. Common causes include the presence of some other medical problems, such as mononucleosis, hepatitis, and some types of genetic disorders. The treatments prescribed depend on the specific diagnosis.
Symptoms
The most common symptom of hepatosplenomegaly is pain in the upper right side of the abdomen. There may also be obvious swelling, particularly on the right side of the abdomen, as well as tremors and fever. Many people with this condition experience gastrointestinal problems such as stomach pain, nausea, vomiting, diarrhea, and changes in the color of urine and stool. 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 causing the swelling.
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Common causes of hepatosplenomegaly are mononucleosis, hepatitis, and lysosomal storage disorders (LSD). Mononucleosis is spread through saliva and mucus and can cause a high fever, swollen lymph nodes, and severe sore throat. Patients diagnosed with mono are most often between the ages of 15 and 17, and most of them recover fully after the virus has run its course. Antibiotics generally don’t work in treating this type of virus, although some health care specialists may prescribe corticosteroid medications to help relieve swelling in the throat.
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 usually involves several rounds of antiviral medication.
LSDs, a group of about 50 rare genetic disorders, can also cause swelling of the liver and spleen. The most common LSDs are Gaucher, Niemann-Pick and Tay-Sachs diseases. Each is usually diagnosed in early childhood and can cause death shortly thereafter. There is no cure for LSD, but treatment with bone marrow transplantation and enzyme replacement therapy can relieve some symptoms.
Other causes of hepatosplenomegaly can include tuberculosis, malaria and some forms of cancer. Certain autoimmune disorders can also lead to this condition, including systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis. Parasitic infections, chronic alcoholism, and cat scratch fever are also associated with swelling of the liver and spleen.
Diagnosis
Hepatosplenomegaly is usually diagnosed with an ultrasound or computed tomography (CT) scan of the abdomen. If a healthcare provider suspects a person has a disease affecting the liver and spleen, they will usually order tests for that condition as well. For example, if a person comes in with jaundice and complains of abdominal pain, the health care provider might test them for hepatitis and do a scan of their abdomen.
Treatment
Treatment for hepatosplenomegaly largely depends on the underlying cause. Most of the time, when treated, the swelling will naturally subside. In those with conditions that can’t be treated, treatment focuses on managing symptoms and improving liver and spleen function. This includes things like enzyme replacement therapy, which can help reduce the size of your liver and spleen, and avoiding things that put stress on your liver, like drinking alcohol or taking nonsteroidal 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 severe internal bleeding and death.
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