Enlarged Spleen - Cause

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What are the causes of an enlarged spleen?

Blood disorders

The spleen will enlarge when it performs more of its duties to filter blood or to manufacture blood cells. Therefore, any disease or condition that damages red blood cells, and requires them to be filtered and removed from the blood stream, will cause the spleen to become larger.

Conditions such as hemolytic anemia, where red blood cells are damaged and broken down (hemolyzed) can cause the spleen to enlarge. Misshapen red blood cells, like those found in sickle cell disease, thalassemia, and spherocytosis, may be damaged when they try to squeeze through small capillary blood vessels. These damaged red blood cells need to be culled from the bloodstream and are filtered out by the spleen.

Decreased blood flow

The spleen will enlarge if there is a decrease in blood flow through the splenic vein. This may cause spleen congestion and enlargement. This situation may be associated with liver disease and portal hypertension. Damage to liver cells makes it difficult for blood to flow normally, and as blood backs up in the portal vein system, it may also affect pressure in the splenic vein. The decreased ability of blood to drain from the spleen causes it to become congested and grow larger. People with congestive heart failure may have an enlarged liver and spleen because of poor blood flow to and from the heart.


Leukemia and lymphoma may be associated with abnormal white cells that can invade the spleen and increase its size.

Other cancers can spread or metastasize to the spleen and cause it to enlarge.

Metabolic diseases

Certain metabolic diseases may cause the spleen to enlarge, including Hurler Syndrome, Gaucher disease and Niemann-Pick Disease.

In sarcoidosis and amyloidosis the spleen can be involved and become enlarged with the abnormal protein deposits.


Some infections may cause splenomegaly including:

  • Infectious mononucleosis caused by the Epstein-Barr virus
  • Cytomegalovirus
  • Viral hepatitis
  • Malaria
  • Tuberculosis
  • Anaplasmosis


Trauma, for example, from a car accident, can damage the spleen.

Return to Enlarged Spleen (Splenomegaly)

See what others are saying

Comment from: Spleeno, 35-44 Male (Patient) Published: June 12

I have an enlarged spleen for 4 months. Many doctors can't figure out why. It's very painful in the left side and upper abdomen. I have had bladder and urinary pain too, but all tests are normal. I feel like I'm dying.

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Comment from: JoHL, 45-54 Female (Patient) Published: October 01

I have a history of iron deficiency anemia as a child. I was hemolytic when suffering from the usual children's illnesses like tonsillitis. I had glandular fever at 21. Usual blood tests done at that time but an observant person looking at my tests for iron deficiency realized there were lots of spherocytes present in my blood sample. Hemoglobin was 6. Reticulocyte count was 584. Glandular fever lasted 6 months and symptoms returned 1 year later. My enlarged spleen is a result of congenital spherocytosis (hemolytic anemia). I wasn't diagnosed until I was 25 despite a history of all the relevant symptoms throughout my childhood.

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