Is the spleen getting enlarged in HCV?

[Diana66]

Is the spleen getting enlarged in HCV? Is it normal to have a mildly enlarged or a borderline spleen in HCV?

[Diana66]

Thank you Hector

I think they are not sure either. I have asked about the reason for the splenomegaly but did not get an answer from the hepatologist or from the hematologist. I guess they will never be sure. But if is not cirhossis that means chances are is from lymphoma

I am just surprised that even though I had an enlarged spleen 2 years ago nobody bothered to investigate further

I have a friend doing acupuncture and on "checking" to the meridians he said that the spleen is weak. I only managed to do 5-6 sessions and that did not change anything - I really do not like needles

Oh well, we shall see after tx how the spleen will present itself

[HectorSF]

Liver disease as well as lymphomas can cause splenomegaly.
Only your doctors can answer what the underlying cause is.

"Is it normal to have a mildly enlarged or a borderline spleen in HCV? "
No.
If it is caused by liver disease then it indicates some portal hypertension.
Portal hypertension is an increase in the pressure within the portal vein (the vein that carries blood from the digestive organs to the liver). The increase in pressure is caused by a blockage in the blood flow through the liver.

Increased pressure in the portal vein causes large veins (varices) to develop across the esophagus and stomach to bypass the blockage. The varices become fragile and can bleed easily.

What causes portal hypertension?
The most common cause of portal hypertension is cirrhosis, or scarring of the liver. Cirrhosis results from the healing of a liver injury caused by hepatitis, alcohol abuse, or other causes of liver damage. In cirrhosis, the scar tissue blocks the flow of blood through the liver and slows its processing functions.
Portal hypertension may also be caused by thrombosis, or clotting in the portal vein.

Normal portal pressure is generally defined between 5 and 10mm Hg. Once the portal pressure rises to 12mm Hg or greater, complications can arise, such as varices and ascites. Indeed, esophageal varices are responsible for the main complication of portal hypertension.

Ultrasonography is a safe, economical, and effective method of screening for portal hypertension. Computed tomography (CT) scanning and magnetic resonance imaging (MRI) can be used when ultrasonographic findings are inconclusive.

What are the symptoms of portal hypertension?

* Reduced levels of platelets or decreased white blood cell count.

* Gastrointestinal bleeding; black, tarry stools or blood in the stools; or vomiting of blood due to the spontaneous rupture and hemorrhage from varices.

* Encephalopathy, confusion and forgetfulness caused by poor liver function and the diversion of blood flow away from your liver.

The spleen of a normal, healthy adult is about 10 cms long and 3 cms thick

Talk to you doctors to learn more about your particular condition.
Hector

[Diana66]

Congrats Frijole, I am so happy for you

I did not have a biopsy but only a Fibroscan (only Fibroscan is done now in NZ). In May I had a 10.2kPa which is severe fibrosis but not cirrhosis (12.5Kpa)

I remember I had the same size spleen 13.4cm on an Ultrasound I have done early 2010. Nobody seemd concerned and I only discovered HCV this year after lymphoma diagnose.

Portal hypertension was not mentioned 2 years ago or this year ( I had ultrasounds and CT scans). How is portal hypertension diagnosed anyway? From ultrasounds?

[PJ1966]

Congratulation Frijole on your und.....great group of support folks and I'm sure you're on the road to SVR!

[frijole]

As copyman said, you can have a slightly enlarged spleen without having cirrhosis.    A book I am reading said a third of hepatitis patients have enlarged spleen.  Mine is slightly enlarged. I don't have portal hypertension but I do have early cirrhosis.  have you ever had a biopsy ?  I don't know if the spleen will reduce in size after successful tx, but I will look at that personally, since I have to have ultrasounds 2x a year.  So far, 2 months post tx I am still UND.

[copyman]

Yes, Having Hep C without severe liver damage can cause an enlarged spleen in some.  

No rhyme or reason with this disease. Same way some people with severe liver disease don't have any symptoms.

[Diana66]

Thank you OH

I think I had a slightly enlarged spleen for the last couple of years but according to the Fibroscan I do not have cirrhosis so I am a bit confused. I was hoping that maybe after tx the spleen will go down to a normal size

[orphanedhawk]

The spleen gets enlarged from cirrhosis which can be caused by hep C.

I copied this from an answer Hector gave to a similar question about an enlarged spleen.
*                  *                       *                         *                        *                       *
Usually you will not have an enlarged spleen unless you have advanced liver disease. You need to find out the exact status off you health and treat your hepatitis C while you are healthy enough to still be treated.

"Blood flows from the spleen..... through the portal vein.... then through the liver.
Scar tissue in the liver (caused by scaring of the liver/cirrhosis) can interfere with that blood flow...... causing pressure to build up in the portal vein (portal hypertension), and the spleen to enlarge (splenomegaly).
As the spleen enlarges, it traps platelets. (The amount of platelets in the bloodstream is reduced.)
So usually--- people with cirrhosis end up having a problem with portal hypertension and an enlarged spleen, and a reduced platelet count in the bloodstream."