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Hypersplenism: causes, symptoms, diagnosis, treatment
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Last reviewed: 05.07.2025
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Treatment hypersplenism
Treatment is directed at the underlying disease. However, if hypersplenism is the only, most severe manifestation of the disease (eg, Gaucher disease), splenic ablation by splenectomy or radiation therapy may be indicated. Since the intact spleen has protective functions against infections with encapsulated bacteria, splenectomy should be avoided if possible, and patients undergoing splenectomy should be vaccinated against infections caused by Streptociccus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae. After splenectomy, patients are especially susceptible to the development of severe sepsis, so if fever develops, such patients should be examined by a physician with the appointment of empirical antibiotic therapy.
Indications for splenectomy or radiation therapy in hypersplenism
Indications |
Example |
A hemolytic syndrome in which the shortened survival of red blood cells with intracellular abnormalities is further reduced by splenomegaly |
Congenital spherocytosis, thalassemia |
Severe pancytopenia with massive splenomegaly |
Lipid storage diseases (spleen size can be 30 times larger than normal) |
Vascular stroke involving the spleen |
Recurrent infarctions, bleeding from esophageal varices associated with intense venous return of the spleen |
Mechanical trauma to other abdominal organs |
Stomach with early satiety, left kidney with calyceal obstruction |
Severe bleeding |
Hypersplenical thrombocytopenia |