Published on July 6, 2016
Is it normal for an ET patient to experience spleen pain? Why does the spleen enlarge? Dr. Mark Heaney of Columbia University Medical Center responds to spleen-related questions from the Patient Power community. He discusses reasons for pain, including micro-infarcts and splenomegaly and also helps viewers to understand enlarged spleen and the risk for rupture.
The Ask the Expert series is sponsored through an educational grant to the Patient Empowerment Network from Incyte Corporation.
Transcript | Is Occasional Spleen Pain Normal for an MPN Patient Without Splenomegaly?
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Kim writes in, “Is it normal for an ET patient to have occasional spleen pain even without splenomegaly, I guess an enlarged spleen, and why is the spleen so important in ET? Can we do anything to support spleen health?”
So spleen is frequently enlarged in ET like the other MPNs. Some patients who don't have enlarged spleens can have spleen pain. I'm not sure that we always understand why there's pain, but I think that patients with ET have a higher risk of microinfarcts. Those microinfarcts can be painful. I don't think that they're really dangerous, and splenomegaly is something that many patients with MPNs live with. It's really only when the spleen gets very, very large that it presents a real threat to health. When it's large but not very, very large, it can have an effect on lifestyle. It can press up against the stomach. It can make it hard to eat a full meal, but splenomegaly by itself doesn’t always represent a huge threat to the patient's well-being.
Couple of related follow-up questions. So I know in years past I used to hear that sometimes the spleen would be removed. Is there the need to do that, or are people to worry about a spleen rupture?
Yeah, there are some patients where spleen pain and spleen enlargement is the primary symptom that they have and for those patients, taking out the spleen can sometimes help. Although that's something that we do much less commonly now that we have more effective drugs. I think splenic rupture is something that's a theoretical concern, and I know that it exists in the literature. I think patients who have very enlarged spleens do have to be careful about trauma. So it's not the time to pick up rugby or hockey, but for most patients rupture is not a huge concern.