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Enlarged spleen : leukemia or infection ?

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I am a 33 yo male who has been healthy up until about a yr ago. For the past year I have become very fatigued; just basically no energy. I saw a dr for an unrelated problem (sudden rapid heart rate) that was diagnosed as benign. However, the bloodwork showed that my white cell count was high at 18. The Dr Didn't seem too concerned and took no action. I later developed a pain in my side under my ribs where the spleen is located. It lasted for about 2 months and went away. I had started to be concerned but when it went away I put it out of my mind. Another episode of svt sent me to the Dr. Again. Still it was determined to be no big deal but the bloodwork showed I still had a high white count at 15. I didn't tell him about the pain as it was gone then. Then pain has returned after 2 months of being gone. I am still exhausted as usual with the pain and headaches now and a general achiness. My question is would an enlarged spleen from leukemia or other cancer come and go like that? Thanks.

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replied June 26th, 2007
Leukemia Answer A2989
Pain under left ribcage doesn’t mean that you are experiencing an enlarged spleen. If the spleen was enlarged it could be palpated. Normal spleens can’t be registered on palpation. Enlarged spleens can be due to many reasons including leukemia.

A high white blood count is usually caused by infection. Leukemia is also possible, although it occurs much less frequently than infection. During leukemia not only is the white blood count increased, but also there are pathologic forms of white blood cells (WBC) present in the blood.

Increased granulocytes indicate a bacterial infection while increased lymphocytes indicate a viral infection. Extremely increased WBC (above 50000/ml which is not in your case) is a case that is a suspect for leukemia, but as I said previously, pathologic forms of WBC should be detected in the blood to confirm leukemia. It seems likely that in your case, infection is a more probably explanation than leukemia. You should visit your GP and eventually an internist for further diagnostic procedures including a differential blood count.

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