What causes splenomegaly in infective endocarditis?
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Splenomegaly is an enlargement of the spleen[1]. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen. Splenomegaly is one of the four cardinal signs of hypersplenism which include: some reduction in number of circulating blood cells affecting granulocytes, erythrocytes or platelets in any combination; a compensatory proliferative response in the bone marrow; and the potential for correction of these abnormalities by splenectomy. Splenomegaly is usually associated with increased workload (such as in hemolytic anemias), which suggests that it is a response to hyperfunction. It is therefore not surprising that splenomegaly is associated with any disease process that involves abnormal red blood cells being destroyed in the spleen. Other common causes include congestion due to portal hypertension and infiltration by leukemias and lymphomas. Thus, the finding of an enlarged spleen, along with caput medusae, is an important sign of portal hypertension.
Causes
The most common causes of splenomegaly in developed countries are infectious mononucleosis, splenic infiltration with cancer cells from a hematological malignancy and portal hypertension (most commonly secondary to liver disease, and sarcoidosis). Splenomegaly may also come from bacterial infections, such as syphilis or an infection of the heart's inner lining (endocarditis).[10]
The possible causes of moderate splenomegaly (spleen <1000 g) are many, and include:
- Splenomegaly grouped on the basis of the pathogenic mechanism
- Increased function Abnormal blood flow Infiltration
- Removal of defective RBCs
- spherocytosis
- thalassemia
- hemoglobinopathies
- nutritional anemias
- early sickle cell anemia
- Immune hyperplasia
The causes of massive splenomegaly (spleen >1000 g) are
- chronic myelogenous leukemia
- myelofibrosis
- malaria
- splenic marginal zone lymphoma
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