The liver and spleen share common blood circulation pathways. Due to the circulatory link between the liver and spleen, many disease processes affect both organs. Infections, blood cell diseases, liver diseases, cancer and inherited disorders can adversely affect the liver and spleen, causing enlargement of both organs.
Chronic Hepatitis and Cirrhosis
Any disease process that causes ongoing liver inflammation--chronic hepatitis--and subsequent liver scarring can lead to cirrhosis. The National Institute of Diabetes and Digestive and Kidney Diseases explains that extensive liver scarring that disrupts the normal structure and blood flow through the liver defines cirrhosis. Many disorders can cause chronic hepatitis and liver cirrhosis. Common examples include alcoholic hepatitis, chronic viral hepatitis, autoimmune hepatitis, nonalcoholic steatohepatitis, primary sclerosing cholangitis, cystic fibrosis and hemochromatosis. The impedance of blood flow through a scarred liver causes a circulatory backup that adversely affects the spleen, causing enlargement. Liver and spleen enlargement prove common physical findings among people with active liver disease and cirrhosis.
Hemolytic Anemias
Hemolytic anemias are disease processes that cause premature destruction of red blood cells. Red blood cell destruction and removal from the circulation occur primarily in the liver and spleen. Specialized cells called macrophages within the liver and spleen accomplish this task. The accelerated rate of red blood cell destruction that characterizes the hemolytic anemias typically causes liver and spleen enlargement. Inherited disorders of the red blood cells prove a frequent cause of hemolytic anemia. With these disorders, the red blood cells assume abnormal shapes, which targets them for early destruction. In a review article published in "American Family Physician," Dr. Gurpreet Dhaliwal and colleagues note that common inherited forms of hemolytic anemia include sickle cell anemia, thalassemia, glucose-6-phosphate dehydrogenase deficiency and hereditary spherocytosis. Medication reactions, autoimmune disorders and infections can also cause hemolytic anemia with concomitant enlargement of the liver and spleen.
Leukemias
Leukemias are a group of cancerous disorders of the white blood cells. These cancers arise from cells in the bone marrow that produce white blood cells. Markedly increased production of the cancerous white blood cell line characterizes leukemia. "The Merck Manual for Healthcare Professionals" points out that leukemic cells frequently invade the liver and spleen, typically causing marked enlargement of the organs. Leukemias are named based on the cell type involved and include acute and chronic lymphocytic leukemia, and acute and chronic myelogenous leukemia.
Infections
The medical reference text "Principles and Practice of Infectious Diseases" explains that bacterial, viral and parasitic infections can cause liver and spleen enlargement. Examples of viral infections that may cause these physical findings include mononucleosis, cytomegalovirus infection and congenital rubella. The bacterial infections tularemia, Q fever and ehrlichiosis can also cause liver and spleen enlargement. Parasitic infections that may lead to liver and spleen enlargement include malaria and schistosomiasis.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Cirrhosis
- Merck Manual for Healthcare Professionals: Cirrhosis, Signs and Symptoms
- "American Family Physician"; Hemolytic Anemia; Gurpreet Dhaliwal, M.D., et al.; June 2004
- University of Maryland Medical Center: Hemolytic Anemia
- American Cancer Society: How is Adult Acute Leukemia Diagnosed?
