ultrasound

So I'm going for an ultrasound tomorrow on my liver and spleen. While showering this morning a couple of questions popped in my mind. Is this a "normal" test? I've not read any discussions on it here. I know that your spleen storing platelets can be a source for ITP, so why isn't this test done in the beginning? Has anyone who had their spleen removed had an ultrasound to see if it was enlarged first? If it's enlarged then I'm thinking having it out may help. Right? Again.....I dunno! UGH.

Several years ago, we were seriously considering having a splenectomy for our son, Brady. When we met with the pediatric surgeon at Children's hospital in Washington, DC, they sent Brady for an ultrasound of his stomach. If I remember right, they specifically looked at his spleen (not liver) and didn't find anything abnormal; the spleen was normal size, etc. In the end, we decided against the splenectomy and haven't had another ultrasound. I think the only reason Brady was referred for the ultrasound was because we were preparing for the splenectomy.

Good luck with yours!

The spleen isn't usually enlarged in ITP so it's a good check to be sure it is ITP. If it is enlarged then they will do more tests just to be sure nothing else is going on.

The doctor can usually tell by palpating the spleen if it is enlarged or not. I don't think many people have scans...some do. It's not a necessary test for ITP, but I'm sure it doesn't hurt anything to have it done.

Ann is right...the spleen isn't normally enlarged with ITP. If it is, it may have to be removed if it is large enough to prevent rupture. There also might be another cause for the enlargement.

Good luck tomorrow!

ok, now I'm really confused. I thought the spleen storing platelets was a contributing factor to ITP. If that is the case why wouldn't it be enlarged? I'm feeling like a newbie here! They're checking my liver because of the Promacta, it can cause liver damage and they want a base point for future reference.
I'm gonna have nightmares tonight!

No nightmares allowed! It will be fine.

The spleen doesn't really store platelets, it does filter them. The spleen stores blood, but shouldn't hoard enough platelets to make it larger. The spleen also produces antibodies that can destroy platelets, but it also produces antibodies that help to fight infections and viruses.

"Physical examination should be normal aside from bleeding manifestations. Mild splenomegaly may be found in younger patients, but moderate or massive splenomegaly suggests an alternative cause."

bloodjournal.hematologylibrary.org/content/115/2/168.full

White pulp is part of the body’s infection-fighting (immune) system that produces white blood cells called lymphocytes. As mentioned, one type of lymphocyte, the B-cell produces ntibodies that protect against invasion by foreign substances, such as bacteria. Red pulp filters the blood, removing unwanted material. The red pulp contains white blood cells called phagocytes that ingest and digest microorganisms such as viruses, bacteria, and fungi. (Macrophages are one type of phagocyte.) The red pulp also monitors red blood cells and platelets, destroying those that are too old or damaged to function properly. Platelets that pass through the spleen are destroyed by special cells in the red pulp called phagocytes. If the platelets are marked with certain autoantibodies, the spleen destroys many otherwise healthy platelets quite
efficiently as they pass through, causing a person to experience thrombocytopenia (low platelets).

www.pdsa.org/assets/pdf/role-function-of-platelets.pdf

Wow - I don't realize how much misinformation there is out there until I start researching again. There are a bunch of articles that state the spleen can be enlarged with ITP, but every single credible article I've ever read says it should not be enlarged due to ITP. I consider Blood Journal to be as credible as it gets.

Hi I am still new to the Discussion group, so I feel I am late on this topic.

An important part of ultrasound is to get a better look at multiple organs. This allows the doctor and you to see if the low platelets counts are indicating other problems with the liver, spleen, and other organs. Palpating is fine if all you are looking for enlargements and hard growths. Small growths may not be found from feeling through the a layer of skin, and fat abdominal wall.

Most hematologists in Fresno are associated with a Cancer group. So they are concerned with everything. I received a quick ultrasound a year ago and they found polyp in my gall bladder. It did not have anything to do with my ITP, but the Hematologist had to focus on getting my counts up so I could get my gall bladder removed. As it turned out the polyp was common type that frequently turned into a cancerous tumor.

Be happy with having you internal organs ultrasounded.

An abdominal ultrasound focusing on the liver and spleen were a standard procedure for our boy here. His spleen was slightly enlarged and we were told it was because of the rate with which is body was destroying platelets. It gets "backlogged" getting them out of the body when they're being destroyed that fast (consider that EVERYTHING his body was producing was being destroyed at that time - he had none). At least that's what they told us. His spleen was not enlarged enough to be palpable from an external exam. There are varying degrees of enlargement.