HCV Information: The Spleen

[Guest guest]

HCV Information: The Spleen

Connections Found Between Spleen and Brain

View Video At J & F Blog

From 2008

In the past, scientists discounted the importance of the spleen, a five-ounce organ located in the upper left abdomen. Now, there's an increasing understanding of the spleen's importance as a part of the immune system, filtering blood and removing old blood cells.Writing this week in the Proceedings of the National Academy of Sciences, a team of investigators reports that the spleen and the brain may be more closely connected than previously thought.The splenic nerve, the researchers find, can communicate with the vagus nerve, which then serves as a conduit of information from the brain to the immune system. Manipulating the central nervous system may allow medical professionals to stimulate activity within the spleen, producing compounds needed to fight infection.Scientist Mauricio s-Ballina, one of the researchers on the project, talks with host Ira Flatow about the findings.

Enlarged Spleen

,

The obstructed flow of blood through the portal vein (portal hypertension) causes the spleen to enlarge by causing an increase in pressure inside the vessels of the spleen. The spleen stores red and white blood cells and platelets (fragment of cells that are used to clot blood). An enlarged spleen traps platelets lowering levels in the blood which can lead to the inability of blood to clot. This is called Thrombocytopenia and is common in people with cirrhosis. You don't necessarily have any symptoms with an enlarged spleen, but you may feel pain or a heaviness in the upper left hand side of your abdomen, and a doctor will be able to tell if it is enlarged by palpitating the area (which means tapping the spleen area to listen for a percussive sound indicating where the edges of the organ are)

Symptoms of an Enlarged Spleen

Most people don't know they have an enlarged spleen because symptoms are rare. People usually find out about it during a physical exam. These are the most common symptoms of an enlarged spleen:.

Being unable to eat a large mealFeeling discomfort, fullness, or pain on the upper left side of the abdomen; this pain may spread to your left shoulderIf you have pain that is severe or gets worse when taking a deep breath, see your doctor right away.If you have an enlarged spleen, you may develop other signs or symptoms, too. These are related to the underlying disease.

They may include signs and symptoms such as:FatigueWeight lossFrequent infectionsEasy bleedingJaundiceAnemia

,Your doctor will ask you questions and do a physical exam to diagnose an enlarged, painful spleen. This involves palpating (examining by touch) your spleen. You will also likely need diagnostic tests to confirm the cause of the swollen spleen. These may include blood tests, an ultrasound, or computerized tomography (CT) scan. In some cases, other tests may be needed.

Spleen Removal Can Help Hepatitis C Patients with Cirrhosis Tolerate Treatment--------------------------------------------------------------------------------By Liz HighleymanMany individuals with cirrhosis related to chronic hepatitis C have low Model for End-Stage Liver Disease (MELD) scores, which are used to prioritize patients for liver transplantation. While it is too early for such patients to undergo transplants, they may have too advanced thrombocytopenia (low platelet levels) to safely receive interferon.The spleen is an abdominal organ that removes old blood cells from circulation. Patients with cirrhosis often have an enlarged spleen (splenomegaly) that removes too many thrombocytes (platelets), cells necessary for blood clotting. This can lead to excessive bleeding or bruising. Hepatitis C therapy with interferon plus ribavirin

can be dangerous in patients with thrombocytopenia. Removal of the spleen (splenectomy) may be performed to correct this condition.In the September 2006 Journal of Clinical Gastroenterology, researchers reported on a series of cases in which splenectomy was performed to raise platelet counts so that cirrhotic hepatitis C patients could be treated with pegylated interferon plus ribavirin.The authors conducted a retrospective chart and computer record review that identified 7 such patients; 4 were men, 3 were women, and the average age was 45 years. All underwent elective splenectomy for thrombocytopenia before starting treatment regimens containing pegylated interferon-alpha 2b (Peg-Intron).Prior to splenectomy, all had thrombocytopenia contraindicating anti-HCV therapy. Most patients (5) had Child's-Pugh Class A cirrhosis, while 2 had Class B.ResultsAll 7

patients experienced increases in their platelet counts by an average of 221 days after spleen removal (mean increase 32,400 to 222,140 cells/mL; P <> http://www.hivandhepatitis.com/hep_c/news/2006/091906_c.htmlSpleen Geography 101: .A part of the lymphatic system, the dark purplish spleen lies in the upper left abdomen protected by the lower ribs. (Our unscientific, people-on-the-street survey suggests wide gaps in anatomy knowledge. "Where is the spleen?" was met with, "Uh, it's somewhere in the main part of the body--not in the extremities.")My, What a Fine Looking Spleen:Size and weight can vary greatly, but in healthy adults the spleen is often about 5 inches long by 3 inches wide and 1 1/2 inches thick. A typical spleen weighs in at about 6 ounces in a healthy adult. But when it becomes enlarged--from malaria or other diseases--it can weigh a hefty 4 pounds or so.They're Not Just for Venting:Not that you've noticed, but the spleen is a busy little part. Its main tasks are to remove

worn-out and damaged red blood cells and platelets and to help the body fight off infection.It filters foreign substances from the blood and produces white blood cells called lymphocytes, which help boost immunity.Whose Spleen Is It, Anyway?:Spleens are handled by internists, though hematologists (physicians specializing in blood and blood-producing organs) and oncologists (physicians specializing in tumors) also provide spleen care, depending on the exact problem.Spleens Gone Bad:So what can go wrong with the spleen? It can get too big, sometimes producing a soreness. Besides malaria, a host of other disorders are accompanied by enlargement of the spleen. A partial list:infectious mononucleosis, chronic liver problems, rheumatoid arthritis, lupus, the early stages of AIDS. In sickle cell anemia

patients, the spleen enlarges and then patients lose spleen function, says Dr. Saxon, professor of medicine and chief of the division of clinical immunology at UCLA.Patients with Gaucher's disease (a disorder of fat metabolism) have enlarged spleens, as do people with lymphomas and people with idiopathic thrombocytopenic purpura (ITP), a systemic illness marked by low platelet counts, weakness and anemia.The spleen can also get ruptured in car accidents, falls or stabbings.If the spleen is injured seriously, or otherwise causes too much trouble, it's likely to get yanked, although in some instances it is repaired.Spleenless Wonders:Yes, you can live a full life without your spleen.About 1% of the population is spleenless, estimates Dr. Lawrence May, an internist at Encino-Tarzana Medical Center.Among the spleenless is talk show host Jay

Leno. In his book "Leading With My Chin" (Harper, 1996), he describes his childhood trip down the banister that ended at the hospital, where he and his spleen parted company.Spleen Understudies:The spleen's tasks are largely taken over by other parts of the lymphatic system and the liver. Oddly, some people--no one's quite sure how many--have a spare spleen. An accessory spleen, as it's known, is not rare, Saxon says.Spleened Versus Spleenless:"On paper, spleenless is not as good as someone who has a spleen," Saxon says, referring to overall health. "They are more susceptible to infection," he says. Those who have lost a spleen to rupture are generally healthier than those who are spleenless due to lymphoma, for instance, Saxon notes.Folks without a spleen should take some precautions,

experts concur.Among them:Get vaccinated against pneumonia and always alert a new doctor or dentist to your condition. When fever strikes, people without a spleen can get sicker quicker, May says.And dentists may want to take extra precautions to minimize infection risks, says Dr. Sung, a dentist and program director of the UCLA hospital dentistry program.People without spleens might also want to note that fact on a medical information bracelethttp://www.hepatitis-central.com/hcv/whatis/spleen.html

http://Hepatitis Cnewdrugs.blogspot.com/2010/05/information-spleen.html