Thrombocytopenia and splenomegaly often occur together. Thrombocytopenia means that a person has an abnormally low platelet count, while splenomegaly means the spleen is larger than it should be.

When the spleen becomes enlarged, it may store more platelets than normal. This causes fewer platelets to be present in the bloodstream. This may affect the blood’s ability to clot, increasing the risk of excessive bleeding.

An enlarged spleen can be a symptom of many different conditions. It can be a transient state, such as when a person has an infection. It can also result from a chronic medical condition such as liver disease. It is important to diagnose and treat the underlying medical condition.

Read on to learn more about thrombocytopenia and splenomegaly.

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Many conditions can cause thrombocytopenia. For example, the bone marrow might not make enough platelets, or the body might destroy platelets.

Often, the body has enough platelets. However, the spleen retains them. In a healthy person, the spleen stores about one-third of the body’s platelets. Splenomegaly results when the spleen becomes enlarged, usually because of another condition. In splenomegaly, the spleen retains too many platelets.

When a person has splenomegaly, their spleen may be congested with platelets, and their blood may not have enough platelets.

Learn more about thrombocytopenia.

Hypersplenism is when the spleen is overactive, causing it to clear blood cells from the body too quickly. It is a complication of splenomegaly. However, not all cases of splenomegaly cause hypersplenism.

The key difference between the two is that hypersplenism is a change in the function of the spleen that causes the spleen to be overly active.

Splenomegaly is a change in the structure of the spleen, causing an enlargement in the spleen that a doctor may feel during an exam.

Some conditions that can cause splenomegaly include:

Learn more about splenomegaly.

A person with thrombocytopenia, including from splenomegaly, may not have any symptoms initially.

If platelet counts drop, a person may have spontaneous bleeding or unexplained bruises. This might include nosebleeds in a person who has not had them before, bleeding gums, or excessive bleeding in response to minor injuries such as a paper cut.

A person with low platelets may also bleed longer than usual. This may include having heavy periods, bruises that heal slowly, or bleeding in response to minor injuries.

People with splenomegaly may also experience the following symptoms:

  • pain or discomfort in the upper left abdomen
  • pain in the left shoulder that radiates from the abdomen
  • bloating
  • a puffy stomach
  • weight loss
  • feeling abnormally full
  • low appetite

Additionally, a person may have symptoms of an underlying illness that causes splenomegaly. These symptoms vary. However, they might include:

Because the symptoms vary so much, it is not possible to diagnose splenomegaly based on symptoms alone. A person should see a doctor for any of the above symptoms, especially if they get worse or do not resolve quickly on their own.

Treatment for splenomegaly-related thrombocytopenia depends on the underlying cause. Identifying the cause is important for preventing the condition from worsening and preventing complications related to underlying conditions.

Because thrombocytopenia can increase the risk of dangerous bleeding, a person may require blood transfusions if they have very low platelets or are undergoing surgery. It is important to take proactive measures to reduce the risk of injury.

When the spleen is enlarged, the risk of rupture increases. Splenic rupture is a life threatening complication that requires immediate medical care.

The prognosis and effectiveness of treatment depend on the splenomegaly’s underlying cause.

Complications can occur from splenomegaly or thrombocytopenia.

The main complication of splenomegaly is a ruptured spleen, which can cause life threatening bleeding and other serious complications.

Potential complications of thrombocytopenia include:

A person can also experience complications related to the underlying illness that caused splenomegaly. For example, an infection might spread or liver disease might lead to liver failure.

Speak with a doctor about any complication concerns.

A person should seek immediate emergency care if they experience sudden intense upper abdominal pain, weakness, or dizziness, or experience a blow to the abdomen when they have an enlarged spleen. This could signal a ruptured spleen.

Contact a doctor if:

  • A person has unexplained ongoing abdominal pain.
  • A person bruises easily or heals slowly.
  • A person experiences unexplained spontaneous bleeding.
  • A person has any medical symptom for which they do not know the cause or which does not go away on its own.

Splenomegaly can be a fleeting problem that goes away on its own. It can also be the product of a serious medical condition requiring treatment.

Effective management of the underlying problem that causes thrombocytopenia or reversal of thrombocytopenia generally leads to a gradual resolution of the splenomegaly.

Both conditions can cause serious complications, including life threatening bleeding and a ruptured spleen. People who have symptoms of either condition should see a doctor. Diagnosing the underlying cause is key to treating both conditions.