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Enlarged Spleen in Children

Enlarged Spleen in Children

The spleen is an oval-shaped organ that is located between the stomach and the diaphragm, on left side of the human body. This HealthHearty write-up provides information on the causes, symptoms, and treatment of an enlarged spleen in children.
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Medically referred to as splenomegaly, enlargement of the spleen could be caused by a wide range of reasons. Spleen performs various vital functions, which include acting as a reservoir for white blood cells and platelets, which in turn are essential for the coagulation or clotting of blood. As a part of the immune system, it filters the blood. White blood cells that are produced in the spleen help destroy bacteria, dead tissue, and foreign bodies. Old and defective red blood cells are also recycled in the spleen.

There are times when the spleen might get enlarged. Normally, when the tip of the spleen can be felt beyond 2 cm below the left costal margin, it is considered to be abnormal. When the spleen gets enlarged, it can trap and store a larger number of blood cells and platelets. It can even trap and destroy the normal red blood cells with the abnormal ones. This can cause the levels of blood cells and platelets in the bloodstream to decline. If the spleen is unable to perform its functions properly, it could give rise to health problems.
Contributing Factors
The enlargement of the spleen could occur due to:
  • Infections such as infectious mononucleosis, malaria, tuberculosis, hepatitis, infection caused by cytomegalovirus (CMV) or other viruses, bacterial infection, protozoal infection, or fungal infection
  • Autoimmune conditions such as juvenile rheumatoid arthritis
  • Premature destruction of red blood cells (hemolysis) due to hereditary spherocytosis, sickle cell anemia, or thalassemia
  • Acute lymphoblastic leukemia (ALL), Hodgkin's disease and non-Hodgkin's lymphoma (NHL), acute or chronic myeloblastic leukemia, neuroblastoma
  • Inherited diseases such as Gaucher's disease, Niemann-Pick disease, or other storage disorders
At times, the condition could be asymptomatic. Sometimes, the affected child might experience:
  • Pain and fullness in the upper left abdomen or in the back
  • Feeling of fullness in spite of eating very little food
  • Pain might be radiated to the left shoulder (a sign of damaged spleen due to the inadequate blood supply to the spleen)
  • Tendency to bleed easily
  • Anemia
  • Fatigue
  • Weight loss
  • Jaundice (if liver is also enlarged)
  • Susceptibility to infections or diseases
Diagnosis and Treatment
A deep palpation of the left upper abdomen during the physical examination can help in diagnosing an enlarged spleen. Other tests that might be conducted include:
  • Complete Blood Count
  • Blood smear
  • Metabolic panel test
  • Liver function test
  • CT Scan/Ultrasonography/MRI
Once the underlying cause of the enlargement of the spleen is identified, suitable treatment options can be recommended. In case of infections, drug therapy can prove to be beneficial. The treatment could also be symptomatic. For instance, blood transfusions could be recommended in case of children affected by severe anemia or thalassemia. Radiation therapy and chemotherapy might be recommended in case of cancer.

In some cases, a child might be affected by hepatosplenomegaly, which refers to the enlargement of both liver and spleen. This is a serious medical condition, which also has to be treated at the earliest. The treatment would also vary, depending on the underlying cause. Only in severe cases, where other treatment options are not working, the removal of spleen is recommended. It must be noted that the risk of certain infections increases after the removal of the spleen. Thus, doctors recommend it only if the pros of the surgical removal of spleen outweigh the cons.
On a concluding note, medical assistance must be immediately sought if a child has been experiencing any of the aforementioned symptoms. Prompt diagnosis and treatment is essential to prevent the complications associated with an enlarged spleen.
Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.