What causes an enlarged spleen and abnormal levels of GGT enzymes, vitamin B12, and platelets?

Question

Hi doctor,

I am a 37-year-old male. I am six feet tall and weigh 180 lbs. I recently was found with an incidental finding of a slightly enlarged spleen about four years ago. It is 15 cm in size, and it has not increased. My spleen was found to be large because of the low platelets I have. It has been between 145 to 160 K/uL for more than eight years. I have been tested for every gene, and other FISH blood tests were all negative. All major tests were performed in a clinic where I went and saw an oncologist and hepatologist. The test results today revealed abnormal enzyme levels (high GGT at 77 U/L), vitamin B12 low at 219 pg/mL, and platelets at 144 K/uL. Someone suggested I consult a liver expert. Please advice.

Answer 1

Hi,

Welcome to icliniq.com.

I thoroughly read your query and understand your concern.

All your investigations are normal. Platelet is also fine. It seems that an enlarged spleen is unlikely here. But still, if it is there, we need to find the cause. It does not look serious, as there is no jaundice, no bleeding, and no increase in size. I would like to suggest a few investigations.

Ultrasound of abdomen with doppler portal and hepatic veins.
LFT (liver function test).
CBC (complete blood count) with reticulocyte counts and peripheral smear examination.
Hb (hemoglobin) electrophoresis.
Fibroscan of the liver.

I want details of the previously done investigations. The causes could be non-cirrhotic portal fibrosis, extrahepatic portal vein obstruction, hemolytic anemia, etc. A treatment plan can be suggested after going through the reports. Please return for review with reports.

Hope this has answered your query.

Kind regards.