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HYPERSPLENISM
History: First described by Wiseman and Doan in 1942
Definition: A syndrome characterized by:
1. Splenomegaly
2. Blood cytopenia(s)
3. Compensatory hyperplasia of the bone marrow (BM)
4. Correction of cytopenia(s) with splenectomy (rarely done today)

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Causes:
1. Cirrhosis & portal hypertension (PH)
2. Congestive splenomegaly
3. Gaucher disease
4. Leukemia/lymphoma
5. Sarcoidosis
6. Malaria
7. Schistosomiasis

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Mechanisms:
1. Sequestration of blood cells in spleen (primary mechanism)
2. Increased splenic destruction of blood cells (minor role)
(In the 1940s there was an opposing argument that the spleen releases humours which suppress blood cell production in/release from BM)

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Treatment:
1. Treat underlying cause
2. Therapeutic splenectomy (relative indication)
3. Splenic irradiation (relative indication)