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Splenectomy

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By Editorial Team

2 min read

Reviewed by: HU Medical Review Board | Last reviewed: August 2024 | Last updated: August 2024

An enlarged spleen (splenomegaly) is a common symptom of lupus, occurring in 10 to 46 percent of those with active disease. It is generally caused by blood abnormalities caused by the inflammation of lupus.1

For most people with lupus who have an enlarged spleen, it is a mild to moderate complication that can contribute to low platelet counts (thrombocytopenia). In most cases, people with lupus have low platelet counts because their immune system mistakenly attacks healthy platelets, which are then trapped in the spleen.2

It is rare for an enlarged spleen to become serious. But when platelet counts become very low and do not improve with medicines, removing the spleen (splenectomy) may help.2

What is a splenectomy?

A splenectomy is the medical term for surgery to remove your spleen. The surgery may be performed laparoscopically (minimally invasive surgery) or open (traditional) surgery.1,2

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When is a splenectomy recommended?

At one time, splenectomy was the only option to treat thrombocytopenia caused by lupus. Today, many doctors prefer to treat low platelet count with steroids and other immunosuppressants.1,2

Is splenectomy safe for people with lupus?

While doctors prefer to use drugs to treat thrombocytopenia caused by an enlarged spleen, removal of the spleen works well for many people with lupus. Of those people who have their spleen removed, some studies show success rates as high as 60 percent in relieving low platelet counts.1

One small study from Mexico found that 85.7 percent of those who had the surgery achieved complete remission of low platelets and had to take less prednisone (steroids) than the year before surgery.3

Splenectomy precautions for people with lupus

People with lupus tend to be sicker and more vulnerable to complications after surgery than people without lupus. That is why people with lupus must be monitored closely before, during, and after any surgery.4

Major surgery such as a splenectomy will need to be planned ahead of time and coordinated with the person’s rheumatologist and hematologist. This allows time to stop or start taking medications that may increase the risks of surgery and recovery.4

A large study found that people with lupus experienced much higher rates of serious complications in the 30 days after major surgery. The most common problems were:5

  • Kidney failure
  • Pneumonia
  • Blood clots in the lungs or brain
  • Blood poisoning (septicemia)

During surgery, anyone with lupus must be watched closely to avoid organ damage and blood clots. After surgery, 10 to 35 percent of people with lupus have an increased risk of blood clots in the legs (deep vein thrombosis). To prevent infections post-surgery, vaccines for flu, pneumonia, and meningitis may be recommended.1,4

Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.