Hepatosplenomegaly: Symptoms, Causes, Risk Factors, Diagnosis, Complications and Treatment

It is a disorder in which the liver and the spleen swell beyond their average size due to several causes.

Known as HPM, the name of this condition, hepatosplenomegaly, comes from the two words that comprise it:

  • Hepatomegaly: swelling or enlargement of the liver.
  • Splenomegaly: swelling or gain of the spleen.

Not all cases of HPM are severe. Some can be clarified with minimal intervention. However, HPM may indicate a severe problem, such as a lysosomal storage disorder or cancer.

Roles of the liver and spleen

The liver has a variety of functions that include blood detoxification, protein synthesis, and the fight against infections. It also has a vital role in producing amino acids and bile salts.

Your body needs iron to make red blood cells, and your liver processes and stores that iron. Perhaps the best-known role of your liver is the processing of waste matter from your body, which can then be excreted.

The spleen is one of the organs of your body that, in general, is less known by most people.

The spleen has an important place in your immune system. It helps you identify pathogens, bacteria, viruses, or microorganisms capable of causing diseases. Then he creates antibodies to fight them.


Your spleen also purifies the blood and is made of the red and white pulp needed to produce and purify the blood cells.


People with hepatosplenomegaly may report one or more of the following symptoms:

  • Fatigue.
  • Pain.

Other symptoms, which can be severe, include:

  • Abdominal pain in the upper right region.
  • Sensitivity in the right part of the abdomen.
  • Nausea and vomiting.
  • Swelling of the abdomen
  • Fever.
  • Persistent itching
  • Yellow eyes and skin indicate jaundice.
  • Brown urine.
  • Stools of clay color.

Risk factor’s

Hepatomegaly risk factors include:

  • Obesity .
  • Alcohol addiction.
  • Liver cancer.
  • Hepatitis.
  • Diabetes.
  • High cholesterol.


Splenomegaly is caused by hepatomegaly approximately 30% of the time. There are many different potential causes of liver disease:

  • Infections
  • Acute viral hepatitis.
  • Infectious mononucleosis, also known as glandular fever or the “kissing disease,” is caused by the Epstein-Barr virus.
  • Cytomegalovirus is a condition in the herpes virus family.
  • Brucellosis is a virus transmitted through contaminated food or contact with an infected animal.
  • Malaria is an infection transmitted by mosquitoes that can be life-threatening.
  • Leishmaniasis is a disease caused by the Leishmania parasite and disseminated through a sandfly bite.
  • Schistosomiasis is caused by a parasitic worm that infects the urinary tract or intestines.
  • Septicemic plague is caused by an infection by Yersinia pestis and can be life-threatening.
  • Hematological diseases.
  • Myeloproliferative disorders, in which the bone marrow produces too many cells.
  • Leukemia or cancer of the bone marrow.
  • Lymphoma or a tumor of blood cells that originates in lymphatic cells.
  • Sickle cell anemia is a hereditary blood disorder found in children whose hemoglobin cells can not transfer oxygen.
  • Thalassemia is a genetic condition of blood in which hemoglobin is abnormally formed.
  • Myelofibrosis is a rare cancer of the bone marrow.
  • Metabolic diseases.
  • Niemann-Pick disease is a severe metabolic disorder involving fat accumulation in cells.
  • Gaucher’s disease is a genetic condition that causes fat accumulation in different organs and cells.
  • Hurler’s syndrome is a genetic disorder with a higher risk of premature death due to organic damage.

Other conditions

  • Chronic liver disease, including chronic active hepatitis.
  • Amyloidosis is a rare and abnormal accumulation of folded proteins.
  • Systemic lupus erythematosus is the most common form of autoimmune disease lupus.
  • Sarcoidosis is a condition in which inflammatory cells are seen in different organs.
  • Trypanosomiasis is a parasitic disease transmitted by the bite of an infected fly.
  • Multiple sulfatase deficiency is a rare enzyme deficiency.
  • Osteopetrosis is a rare inherited disorder in which the bones are more complex and denser than usual.

In children

The common causes of hepatosplenomegaly in children can be summarized as follows:

  • Newborns: storage disorders and thalassemia.
  • Babies: liver unable to process glucocerebroside, which can cause severe damage to the central nervous system.
  • Older children: malaria, kala-azar, enteric fever, and sepsis.


These are some tests that your doctor may request to help make a definitive diagnosis of hepatosplenomegaly. These are:

  • An ultrasound is usually recommended after an abdominal mass is found during a physical examination.
  • A CT scan may reveal enlargement of the liver or spleen and the surrounding organs.
  • Blood tests include a liver function test and a blood coagulation test.
  • An MRI to confirm the diagnosis after the physical examination.


The most common complications of hepatosplenomegaly are:


Treatments for hepatosplenomegaly may vary from person to person, depending on the condition’s cause.

As a result, the best course of action for you is to talk with your doctor about your diagnosis and treatment recommendation.

They can suggest

Make changes in your lifestyle by consulting your doctor. Your general goals should be to stop drinking or, at least, reduce your alcohol consumption as much as possible; exercise as regularly as possible, and enjoy a healthy diet.

Rest, hydration, and medication: some less severe infections that cause hepatosplenomegaly can be treated simply with appropriate drugs and rest while making sure you do not get dehydrated.

If you have an infectious disease, your treatment will be double, medications to relieve symptoms and specific drugs to eliminate the infectious microorganism.

Treatments for cancer: When the underlying cause is cancer, you need appropriate treatments that may include chemotherapy, radiation therapy, and surgery to remove the tumor.

Liver transplant: If your case is severe, such as being in the final stages of cirrhosis, you may need a liver transplant.


Due to the wide variety of causes, hepatosplenomegaly does not have a specific result. Your situation depends on various factors, including the cause, severity, and treatment you receive.

The sooner HPM is diagnosed and treated, the better it will be.

Consult your doctor if you notice unusual symptoms or suspect something is wrong.


Because the causes of hepatosplenomegaly are so diverse, they can not always be prevented. However, a healthy lifestyle can only help. Avoid alcohol, exercise a lot and eat a healthy diet to help minimize the most common risk factors.