Hepatosplenomegaly: Description, Causes and Risk Factors:

Abbreviation: HSM.

HepatosplenomegalyAn enlarged liver and spleen, medically known as hepatosplenomegaly, occur when the liver and spleen swell beyond their normal size. The liver is a large accessory organ in the digestive system, responsible for a number of functions including bile secretion to break down food, storage of iron and vitamins, production of blood proteins, and elimination of old red blood cells. The spleen is part of the lymphatic system, which plays a role in immunity and maintenance of healthy blood cells.

Common causes of hepatosplenomegaly are mononucleosis, hepatitis, and lysosomal storage disease (LSDs).

Mononucleosis spreads through saliva and mucus, and may cause a high fever, enlarged lymph nodes, and a severe sore throat. Patients diagnosed with mononucleosis are most often between the ages of 15 and 17, and most of them make full recoveries after the virus runs its course. Antibiotics generally do not work in treating this kind of virus, although some health care specialists may prescribe corticosteroid medications to help relieve throat swelling.

Another common cause of this condition is acute viral hepatitis. In addition to an enlarged liver and spleen, patients with acute viral hepatitis may also experience poor appetite, fever, and jaundice of the skin or whites of the eyes. Recovery can take up to eight weeks, and treatment normally entails several courses of antiviral medications.

LSDs, a group of about 50 rare genetic conditions, can also cause swelling of the liver and spleen. The most common LSDs are Gaucher's, Niemann-Pick, and Tay-Sachs diseases. Each one is usually diagnosed in early childhood. There is no cure for LSDs, but treatment with bone marrow transplantation and enzyme replacement therapy may alleviate certain symptoms.

Other causes of hepatosplenomegaly may include tuberculosis, malaria, and some forms of cancer. Some autoimmune disorders can also lead to this condition, including systemic lupus erythematosus (SLE) and juvenile rheumatoid arthritis. Parasitic infections, chronic alcoholism, and cat scratch fever are also associated with hepatosplenomegaly.

Risk Factors:


  • Acute viral hepatitis.
  • Infectious mononucleosis.
  • Cytomegalovirus.

Hematological disease:

  • Leukemia
  • Myeloproliferative disease.
  • Lymphoma.
  • Pernicious anemia.
  • Sickle cell anemia.
  • Thalassemia.

Chronic liver disease and portal hypertension:

  • Chronic active hepatitis.
  • Amyloidosis.
  • Acromegaly.
  • Systemic lupus erythematosus.

Because hepatosplenomegaly can be due to serious diseases, failure to seek treatment can result in serious complications and permanent damage. Once the underlying cause is diagnosed, it is important for you to follow the treatment plan that your healthcare professional design specifically for you to reduce the risk of potential complications.


Hepatosplenomegaly may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. The condition may not always present with symptoms, but may be detected by your healthcare provider upon examination. They may include:

  • Abdominal mass.
  • Belching and hiccupping.
  • Easy bleeding or bruising.
  • Fever or chills.
  • Inability to digest large amounts of food.
  • Loose, fatty stools.
  • Vomiting.
  • Yellowing of the skin and whites of the eyes (jaundice).


Hepatosplenomegaly is usually diagnosed with an ultrasound or a computed tomography (CT) scan of the abdomen. If a healthcare provider suspects that a person has a disease that affects the liver and spleen, he/she will usually order tests for that condition as well. For instance, if a person comes in with jaundice and complaining of abdominal pain, the healthcare provider would test him or her for hepatitis as well as doing a scan of the abdomen.

There are a number of diagnostic tests for hepatosplenomegaly to be performed to confirm the exact cause of the disease, they may include:

  • Blood film.
  • Monospot test.
  • Hepatitis tests.
  • Bone marrow aspiration.
  • Test for malaria.
  • Urinalysis.
  • Ultrasound scan.
  • Needle aspiration.
  • CT scan.


The treatment for hepatosplenomegaly largely depends on the underlying cause. Most of the time, when that is treated, the swelling goes down naturally. In those with conditions that cannot be cured, treatment focuses on managing the symptoms and improving the liver and spleen's function. This includes things like enzyme replacement therapy, which can help keep the size of the liver and spleen down, and avoiding things that stress the liver, like drinking alcohol or taking non-steroidal anti-inflammatory drugs (NSAIDs).

NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.

DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.



  1. Juliet Osei Owusuwaa

    I am suffering from Heposplenomegaly (HSM).l got to know this from ultrasound scan and I have done so many test and my is not due to either Monocus disease or hepatitis. My electrophoresis status is CC, could that be the causes of my conditions and what should I do if I want to get pregnant. please I need your help. Thanks


    I am suffering from Heposplenomegaly (HSM).l got to know this from CCT and I have done so many test and my is cause by sarcoidosis. and i have peptic ulcer.i always tired and my breadth is not okay. please I need your help. Thanks

    • maisteri

      The symptoms that bother you are probably related to sarcoidosis. So the best option for you is to visit an infectious disease specialist who will suggest you the appropriate treatment most likely with steroids.


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