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Child has an enlarged spleen and liver. What could be the cause?

Apr 2013
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General Surgeon
Practicing since : 2008
Answered : 9332 Questions
Hello, my daughter has an enlarged spleen since XXXXXXX 2013. She is now 3 and in September we were told her liver is enlarged too. No answer yet to why this is happening. We've been seeing 5 specialist in different specialties and no diagnosis yet
Posted Tue, 3 Dec 2013 in Child Health
Answered by Dr. Ivan R. Rommstein 2 hours later
Brief Answer: Hi and welcome to XXXXXXX Detailed Answer: Dear XXXXX,you may not find diagnosis at all since liver and spleen enlagement in this age can be normal or just sign of some systemic,even viral infection. If her lab findings (bilirubin, LFT, rbc and wbc) are fine,you dont have to be concerned at all. Just repeat abdominal ultrasound in 3 months and verify is there progression in size. As I said, it can be normal,but also some other disorders which manifest liek this are: hemolytic anaemia, trombocytopenia, congenital liver disorders or liver blood flow disorders. If condition doesnt improve and there are abnormal lab findings,you should do more detailed workp up incuding ct scan,hematologic tests and liver biopsy. I hope it wont be necessary. WIsh you good health. Feel free to ask. Regards
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Follow-up: Child has an enlarged spleen and liver. What could be the cause? 22 hours later
We saw at least five specialists and every time was a different thing that she was tested for and results came back negative. What worries me is that she gets nose bleeds almost every night for months. Her blood came back negative for anemia 5 times but I'm worried about her losing all that blood. Thank you
Answered by Dr. Ivan R. Rommstein 2 hours later
Brief Answer: Hi. Detailed Answer: Dont worry about nose bleeding. this is minor bleeding and it cant cause some serious red blood count fall or any other consequances. If this is her only symptom then you really dont have to be concerned. Nose bleeding is seen in children commonly. However,somitmes it can indicate coagulation disorder which can be sign of liver disease. To rule this out you need to check all coagulation factors, protrombine time and trombocyte count. If this is normal,your daughter dont need any treatment.
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