Enlarged spleen

An enlarged spleen traps and destroys red blood cells.

The disorder that caused the spleen to enlarge is treated.

Sometimes the spleen must be removed surgically.

Extremely large spleens cause abdominal pain and a feeling of fullness after eating a small amount of food.

Often, an enlarged spleen also traps platelets and white blood cells, thus reducing their number in the bloodstream.

Mechanical damage to red blood cells

Abnormalities in blood vessels or an artificial or damaged heart valve can break normal red blood cells apart.

The cause of the damage is identified and corrected.

Red blood cells are destroyed in the blood vessels.

Paroxysmal nocturnal hemoglobinuria

The immune system destroys red blood cells.

Hemoglobin from these destroyed cells is concentrated in urine, resulting in dark, reddish urine.

Medications that block the complement system, help relieve symptoms and reduce the risk of blood clots.

People may have severe stomach cramps and clotting in the large veins of the abdomen, brain, and legs.

Symptoms often occur in episodes (paroxysmally), though there is also chronic destruction of red blood cells

Hereditary spherocytosis

Red blood cells become misshapen and rigid, getting trapped and destroyed in the spleen.

Treatment is usually not needed, but severe anemia may require removal of the spleen.

This hereditary disorder can also cause bone abnormalities and growth delays in severe cases

This disorder can cause gallstones.

Transient aplastic crises can occur (when the bone marrow cannot produce enough red blood cells to compensate for the chronic red cell destruction) due to infections, such as parvovirus B19,

Hereditary elliptocytosis

Red blood cells are oval or elliptical in shape rather than the normal disk shape.

Severe anemia may require removal of the spleen.

The anemia is usually mild and requires no treatment.

Red blood cell enzyme abnormalities

Glucose-6-phosphate dehydrogenase (G6PD) deficiency: The G6PD enzyme is missing from red blood cells , making cells more susceptible to destruction.

Pyruvate kinase (PK) deficiency, which is usually present at birth (congenital), also makes red blood cells more fragile.

In G6PD deficiency, anemia can be prevented by avoiding things that trigger it, such as medications.

In PK deficiency, some people may benefit from removal of the spleen and medications for anemia.

G6PD deficiency is a hereditary disorder that almost always affects males.

About 10% of males with African or Black American ancestry and a smaller percentage of people of Mediterranean ancestry have G6PD deficiency.

Pyruvate kinase deficiency is rare.

Other red blood cell membrane abnormalities

Stomatocytosis (where the cell membrane has an abnormal "slit"), which can be inherited or can develop during life (acquired), or in rare cases of low phosphate levels in the blood.

For acquired stomatocytosis, people should avoid triggers (such as alcohol).

For inherited stomatocytosis, rarely removal of the spleen is needed.

For people with low phosphorus levels in the blood, phosphate supplements are needed.

The anemia is usually mild and requires no treatment.