Enlarged Liver/Spleen

Hello. I am a 23 year old male, and do not drink. For the past 4-5 months I have been having upper right quadrant pain/discomfort under ribs and back. In June I had bloodwork done (CBC), which showed elevated liver enzymes, but only slightly elevated. I was then instructed to have an ultrasound, which showed a midly enlarged spleen and liver. I had a Cat-scan done a week later, which stated that my liver was within the normal range but at the upper limit, and that the spleen was still enlarged. I had blood-work done again on July 31, (CBC and liver specific tests)which showed normal liver enzymes and everything else normal. I then saw a GI specialist, who went over the results, ordered a blood protein test ( which came back negative) and he has now referred me to a hematologist.  I have also had a Hep A, B, and C test which was negative as well, otherwise feel great, and have had mono in the past as indicated through my bloodwork. The pain is so so minimal, and more of a mild sensation at times, but the anxiety is what is getting to me. At time I feel mild pain in my lower abdomen, but nothing was found to warrant this. My question is, what could be causing my symptoms? I am not looking for a diagnosis or info in which I will rely upon, but rather an opinion based on what you may have run across before in your field. Thanks a lot, and I appreciate any feedback, as I cannot see the hematologist for some time as I have just relocated and am extremely busy.

[Kevin Pho, MD]

I agree with the workup thus far, including the referral to the hematologist.

The possible causes of an enlarged spleen is long, but can include liver disease, blood disorder, cancer (i.e. lymphoma), infection, or problems with the spleen.  

The specialists you are currently seeing (the gastroenterologist and hematologist) would exclude all of these conditions.

Further workup may include a CT scan, MRI, or PET scan.  Blood tests may also be done if a hematologic disorder is suspected.

These options can be discussed with your personal physicians.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
www.kevinmd.com