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Children's Health

Enlarged Spleen

04/14/2011

Question:

hi doctors my friend is jst 17 years old female and she is in a enlarged spleen disease and she is very upset plz plz i want the best treatment for her plz help her hurry!!

Answer:

Hello! It is a little difficult to answer the question very precisely without knowing why your friend's spleen is enlarged. The two most common causes of an enlarged spleen are infection, either viral or bacterial, and problems with hemoglobin structure in the red blood cells. Other causes are blood cell cancers, congestive heart failure, and autoimmune problems such as systemic lupus erythematosus.

I am guessing that since your friend is 17 years old and still has her spleen that she may have had or currently has infectious mononucleosis, "mono" for short, a viral illness causing a very sore throat and marked fatigue. A substantially enlarged spleen happens in as much as 75% of children infected with the mono virus. This happens for two reasons. The first reason is because the spleen enlarges to produce more lymphocytes to combat the virus causing mono, known as the Epstein-Barr virus. The second reason is that the spleen itself is a large filter for trapping viral and bacterial microbes in order to fight infection.

Because the spleen has enlarged, it is extending below the bony, protection of her ribcage. This places the spleen at great risk for injury, which can result in massive hemorrhaging inside her abdomen and death. If your friend has mono, she needs to know that she must avoid all bumping and jostling in school hallways and other social places. She also cannot participate in contact sports where her spleen may be injured unintentionally.

It takes 4 weeks or more for mono to resolve. Some doctors want to have an ultrasound of the spleen before approving a return to sports and social activities where there is risk of injury to the spleen. There is no medication to speed this process up when the cause is viral.

I hope this information is helpful and that your friend feels better soon.

American Academy of Pediatrics (2009). Red book: 2009 report of the Committee on Infectious Diseases ( 28 th ed.). Elk Grove Village: American Academy of Pediatrics.

McInerny, et al. (2009). Textbook of pediatric care. Elk Grove Village: American Academy of Pediatrics.

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Response by:

Mary M Gottesman, PhD, RN, CPNP, FAAN Mary M Gottesman, PhD, RN, CPNP, FAAN
Professor of Clinical Nursing
College of Nursing
The Ohio State University