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Enlarged spleen
Jun 14, 2009

Dear Dr Henry, I am a 50 year old, HIV + (1991) male. My spleen has been enlarged for the past 6 months. My doctor seems quick to diagnose this condition as a side effect of HIV. I am told my kindy/liver functions look good, my T count is around 250 (has been for years), and my viral load goes form undetectable with blips on the low end. My question to you is this: What should I be asking my doctor to look at as other possible causes? What blood work can be done to truely pin point the cause of the enlarged spleen? Six months of extreme fatuge is beging to affect me emotionally I would just like a solid conformation as to why my spleen is enlarged. Thank you for any input you can give me. Mark

Response from Dr. Henry

Occasionally HIV+ patients develop a large spleen which sometimes is associated with a low platelet count (thrombocytopenia). Other infections (such as mono, histoplasmosis, parastitic infections), tumors (such as leukemia and lymphoma), splenic vein thrombosis, polycythemia, amyloidosis, sarcoidosis, cysts, eosinophilic granuloma, and many other conditions are associated with an enlarged spleen so a full diagnostic work-up is often in order to sort out the numerous possibilities. Often a hematology consultation can be useful. KH



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