Definition and Overview
Hepatosplenomegaly (HPM) is a condition that affects the liver and the spleen. The spleen is an internal organ that helps the body fight infections. The liver, on the other hand, has several functions. It metabolises drugs, detoxifies chemicals, and secretes bile, among others.
HPM occurs when both organs become swollen or enlarged. The condition can be mild, moderate, or severe. It can also be a symptom of more serious medical conditions, including cancer.
Mild cases of HPM can be treated with minimal intervention. Serious cases, on the other hand, often require long-term treatment. This often focuses on resolving the underlying condition. For instance, if the cause is cancer, patients will receive cancer treatment. These can include surgery, chemotherapy, and radiation therapy. In many cases, hepatosplenomegaly resolves once the underlying cause is adequately treated.
The condition can be caused by a wide range of medical problems. This makes it challenging for doctors to diagnose it promptly. Possible causes can include infections, blood disorders, and metabolic diseases. Chronic liver disease, systemic lupus erythematosus, and sarcoidosis are also known causes of the condition.
HPM can affect anybody of any age. It can occur in adults as well as newborns, infants, and older children. It can be a serious condition. Thus, it is important that doctors are able to diagnose it accurately and promptly. The earlier the condition is caught and treated, the better is the patient’s prognosis.
Prompt treatment helps prevent complications from occurring. The most serious complications include liver failure, internal bleeding, and encephalopathy. These can all be life-threatening.
Cause of Condition
Medical conditions that can cause HPM include:
Chronic liver diseases - These include chronic hepatitis, liver cirrhosis, and liver cancer.
Leukaemia, or cancer of the blood
Acromegaly - A hormonal disorder that develops when the pituitary gland produces too much growth hormone.
Sarcoidosis - An inflammatory disease that affects different organs.
Malaria - A serious disease transmitted through the bite of mosquitoes that carry the Plasmodium parasite. When a person is bitten by such mosquitoes, the parasite is released into their bloodstream.
Septicemic plague - A life-threatening blood infection caused by a gram-negative species of bacterium.
Niemann-Pick disease - A disease that occurs due to the buildup of harmful amounts of lipids in various organs.
Because the condition has many possible causes, doctors may take a while to diagnose it. However, this is an important part of the process. Doctors need to find out the precise cause. This is because the treatment of the underlying cause is the first step in managing the condition.
Patients commonly display symptoms of the underlying cause of the condition. They often experience fatigue and pain in and around the affected organs.
Symptoms may depend on the severity of the condition. Patients with severe cases of HPM often suffer from pain in the upper-right quadrant of the abdomen. Vomiting and nausea, as well as jaundice and fever, are also common symptoms.
Patients can also experience abdominal swelling as well as dark-coloured urine and stool.
Who to See and Types of Treatment Available
Patients with hepatosplenomegaly are diagnosed and treated by a group of doctors. Depending on what causes their illness, their medical team may include doctors specialising in blood disorders and cancer care, among others.
During the consultation, the doctor will:
Review the patient’s and his or her family’s medical history. The doctor will also require a list of medications that the patient has been taking for any other illnesses.
Discuss the patient’s lifestyle - The doctor would want to know if the patient smokes or has a history of drug or alcohol abuse.
Tests and procedures used to diagnose the condition include the following:
Imaging tests - Depending on the suspected cause of the condition, imaging tests may include magnetic resonance imaging (MRI), computed tomography (CT) scan, and an ultrasound. These imaging tests provide clear pictures of the internal organs. They can show if the spleen and the liver have become inflamed or enlarged.
Blood and liver function tests - Doctors will perform examinations to determine the presence of other disorders or diseases. These include chronic liver disease, cancer, and anaemia.
Once the condition has been confirmed and the exact cause is identified, treatment is started. Treatment options may include:
Cancer treatment - If caused by cancer, patients may need to undergo surgery to remove the abnormal growth. This can be followed by either chemotherapy or radiation therapy. These therapies are meant to kill remaining cancer cells to avoid recurrences.
Healthy lifestyle changes - Patients who smoke or have drug or alcohol abuse problems are advised to quit as soon as possible. They are also advised to eat a healthy diet and to become more active.
Liver transplant - In most severe cases, patients may require a liver transplant. This procedure involves removing the diseased liver and replacing it with a healthy liver from a donor.