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Forum Name: Hematology Topics

Question: enlarged spleen


 deb44 - Wed Feb 21, 2007 2:46 pm

I'm a 44 year old female. Not on any medication. Have had several months of feeling ill. fatigue (really bad in the evening), achy (sometimes), decreased appetite (lost 20 lbs 2 mos), poor circulation (hand, feet fall asleep every time I even sit down), headaches (not every day), lightheaded (sometimes), left arm pain (in last couple of days only), top left abdomen burns/hurts on and off and so does the top right side). These are the main symptoms. Tests I have had run: blood work numerous times (all came out normal), echocardiogram (I have Mitral Valve Prolapse), hide a scan test on gallbladder (okay), upper gi & colonoscopy (only have gastritis), lung xray (okay), scan of kidney and bladder using dye (report said I have 2 kidney stones and an enlarged spleen) abdominal ultrasound (only said I had a slightly enlarged spleen ).

My question is: would the enlarged spleen have something to do with the way I'm feeling? I told my primary doctor and she shrugged it off. (she didn't see the results though). What kind of doctor would I see for this? I get EXTREMELY tired and fatigued in the evening and I''m concerned about the poor circulation I have. Please give me some direction..

Thanks so much!!
 deb44 - Thu Feb 22, 2007 5:48 pm

no answer yet? I'm really curious as to what to do? Thanks
 deb44 - Wed Feb 28, 2007 9:02 am

Is there an expert out there on spleen issues? Please answer....
 Dr. Chan Lowe - Wed Feb 28, 2007 10:14 pm

User avatar Sorry for the delay.

I suspect that your enlarged spleen may actually be a symptom of an underlying illness. There are several causes of spleen enlargement (splenomegaly). Most commonly, viral illnesses can cause the spleen to enlarge as it helps clear the infection and antibodies. Splenomegaly can also produce pain due to stretching of the capsule encasing the spleen (sort of like the shell of an egg).

Overall your symptoms suggest an infection with a virus such as Ebstein Barr virus or Cytomegalovirus. EBV infection is more commonly known as mononucleosis. These can be tested for with blood tests to help give an idea of whether or not they are at fault.

Poor circulation may or may not be associated with this. Be sure to stay well hydrated to help circulation.

Mitral valve prolapse is extremely common in women and generally not symptomatic. This is likely an incidental finding.

Some of the viruses that can cause these types of symptoms can continue for several weeks (particularly EBV). If you are not overall improving I recommend that you follow up with your doctor. You may also need some follow up blood work if you aren't getting any better, such as a repeat CBC, ESR or CRP (markers of inflammation), and possibly some rheumatic type labs (ANA for example).

Keep in mind the kidney stones as well. They can certainly cause lots of pain (although less likely to cause your other symptoms). Urinary tract infection with resulting kidney infection can also cause some of your symptoms.

Hope this helps.
 deb44 - Thu Mar 01, 2007 5:59 pm

Thanks for your reply. Are there other viruses besides the EBV? I took a mono test about a month ago and it was negative. I also had repeat blood tests last week and all were normal. Would you recommend me seeing a Hematologist if it doesn't get better in a couple of weeks?

Thanks again for your input.
 Dr. Chan Lowe - Fri Mar 02, 2007 12:10 pm

User avatar While EBV is most notorious for causing an enlarged spleen there are many other causes. CMV is a member of the same family and can cause mono-like symptoms. In most mono-like illnesses where EBV is not responsible, CMV is.

Many other viruses can cause a mildly enlarged spleen. Really, any condition that is causing a proliferation of white blood cells can cause the spleen to expand. EBV and CMV are probably the most notable viruses I can think of.

One note about a monospot test. For most people it is pretty good but does have a few false negative results. If there is significant concern, actual EBV antibody titers can be drawn which are much more sensitive and specific than the monospot test.

Hope this helps.
 deb44 - Fri Mar 02, 2007 1:30 pm

Thanks this information will help. I'll talk to my doctor.

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