Splenomegaly is one of the characteristic signs of an overactive spleen. It can cause platelets to pool inside of your spleen and cause thrombocytopenia.

Thrombocytopenia is when you have a low platelet count. Platelets are the special cells that allow your blood to clot.

People with severe cases of thrombocytopenia often bleed excessively and bruise easily. Lower platelet counts are linked to more severe symptoms.

Splenomegaly is an enlarged spleen. It’s a symptom of hypersplenism, which is an overactive spleen. An overactive spleen can lead to platelets pooling in your spleen and reduced platelets circulating through your blood.

Many conditions can cause hypersplenism, such as:

Read on to learn more about the connection between an enlarged spleen and low platelet counts.

Hypersplenism is overactivity of your spleen and splenomegaly is an enlarged spleen. They’re highly related. Splenomegaly is a necessary feature for diagnosing hypersplenism, along with some or all of the following:

Splenomegaly isn’t considered a disease by itself. It’s a symptom associated with many other conditions.

Your spleen is an organ near your stomach. You can live without your spleen, but it plays several important functions, such as:

  • controlling circulating levels of blood cells
  • removing damaged or old red blood cells from your bloodstream
  • helping your body fight infections

Splenomegaly is a defining feature of an overactive spleen. An enlarged spleen increases the number of blood cells that it holds. Thrombocytopenia is a potential complication, largely due to the pooling of platelets inside the spleen.

Typically, the spleen holds about a third of your platelets. However, a severely enlarged spleen may hold up to 90% of the platelets in your body.

Splenomegaly often doesn’t cause symptoms. Symptoms are most likely to appear if your spleen is severely enlarged.

Symptoms of an enlarged spleen can include:

  • feeling full quickly after eating
  • pain behind your ribs on the left side
  • fatigue
  • frequent infections
  • easy bleeding

Symptoms of thrombocytopenia can include:

An enlarged spleen can rupture and cause life threatening bleeding. Healthy spleens can also rupture during traumatic events like car collisions, but enlarged spleens can rupture even with mild trauma.

Thrombocytopenia in people with hypersplenism is usually moderately severe and may cause your platelet levels to drop to below 150,000 platelets per microliter of blood. A healthy platelet count is considered 150,000 to 450,000 platelets per microliter.

Severe thrombocytopenia can cause serious bleeding, including life threatening bleeding in internal organs or the brain.

Splenomegaly often doesn’t cause symptoms, but it’s important to reach out to a doctor if you have pain in your upper left belly, especially if the pain worsens over time.

It’s also important to speak with a doctor if you notice that you’re bleeding or bruising more frequently or severely than usual, which might be a sign of thrombocytopenia.

Thrombocytopenia can have many underlying causes and some of them, like leukemia or hepatitis C, require prompt treatment.

Medical emergency

An enlarged spleen requires prompt medical attention to avoid rupture. A ruptured spleen can cause life threatening internal bleeding. Call emergency medical services or go to your nearest emergency room if you believe you or somebody you know has:

  • severe pain in the upper left abdomen or left shoulder
  • lightheadedness
  • dizziness
  • confusion

Treatment for splenomegaly consists of treating spleen hyperactivity and managing the underlying cause.

For example, if cirrhosis is causing your spleen to enlarge, your treatment for cirrhosis may include:

  • lifestyle changes like avoiding alcohol and quitting smoking
  • taking diuretics to reduce fluid retention
  • taking medications to reduce high blood pressure in your portal vein
  • a liver transplant if your liver is severely damaged

Treatment for hypersplenism includes:

Removal of the spleen is usually reserved for severe cases that can’t be resolved with other treatments.

Here are some questions people have about the connection between thrombocytopenia and splenomegaly.

Is splenomegaly common in thrombocytopenia?

Thrombocytopenia has many potential causes, and most causes aren’t associated with splenomegaly. If your white blood cell count is reduced, you might be more likely to develop infections that can cause splenomegaly.

Can thrombocytopenia cause splenomegaly?

Thrombocytopenia doesn’t directly cause splenomegaly, but splenomegaly can cause thrombocytopenia.

What is the most common cause of splenomegaly?

Liver disease and infections are among the most common causes of splenomegaly. Other common causes include:

Splenomegaly is the medical term for an enlarged spleen. It’s one of the characteristic signs of an overactive spleen. Splenomegaly can cause platelets to pool inside of your spleen and cause thrombocytopenia (low platelet counts).

Thrombocytopenia is when you have reduced platelet counts in your bloodstream. It puts you at risk of prolonged or severe bleeding, even from minor injuries. Lower platelet counts are associated with a higher risk of severe bleeding.