In multiple sclerosis (MS), lesions form in the fatty protective sheath, called myelin, that surrounds the nerves of the brain and spinal cord (central nervous system or CNS). Having this chronic autoimmune disease also increases your chance of having additional health conditions, known as comorbidities. Some members of MyMSTeam have wondered whether MS or MS treatments can affect the spleen or have reported pain or other sensations in the region of their spleen.

“For the last three weeks I have had an increasing tremor, twitch, [and] spasm by my spleen,” shared one member.

“Has anyone had [a] situation where they had trouble regulating their body temp., had night sweats and an enlarged spleen?” asked another member.

No current research indicates that MS or disease-modifying therapies (DMTs) for MS can directly impact a person’s spleen. However, other medical conditions related to MS may. If you have concerns about the health of your spleen, speak with your health care team.

What Does Your Spleen Do?

Your spleen is a small organ (about the size of an avocado or your clenched fist) that sits just above your stomach inside of your left rib cage. As part of your lymphatic system and immune system, your spleen works to keep your body healthy.

Your spleen has multiple functions, including:

• Storing blood
• Filtering blood by removing cellular waste and getting rid of old or damaged blood cells
• Making white blood cells (immune cells) and antibodies that help fight infections
• Maintaining the fluid levels in your body

The spleen is the largest organ in the immune system. It has two types of tissues — the red pulp and the white pulp. The white pulp is where immune cells, including B cells and T cells, mature and stay until the immune system is activated to fight an infection. The red pulp is the part of the spleen that filters the blood.

Does MS Cause Problems With the Spleen?

There does not appear to be a direct connection between MS and problems with the spleen. The lesions caused by MS in the CNS do not directly affect the spleen.

Although MS itself is not known to cause problems with the spleen, other medical conditions related to MS can. For example, some scientists believe a prior infection with the Epstein-Barr virus — which causes mononucleosis (or mono) — may result in genetic changes in some people that raise the risk for the development of MS. The Epstein-Barr virus is known to cause an enlarged spleen.

Do DMTs Increase the Risk of Spleen Problems?

Disease-modifying therapies are prescription medications designed to reduce the frequency of MS relapses or flare-ups and the development of new CNS lesions. The U.S. Food and Drug Administration (FDA) has approved more than 20 DMTs for treating MS.

DMTs work by modifying the activity of different immune cells and proteins. There is no research linking any DMTs or side effects with spleen pain or an enlarged spleen. Talk with your health care provider if you are concerned that your MS therapies are affecting your spleen or other organs.

Common Causes of Spleen Problems

There are many different conditions and injuries that can affect how your spleen works.

The most common problem is splenomegaly, an enlarged spleen. This condition can be dangerous since the spleen can rupture (burst open) or bleed. The following conditions may cause an enlarged spleen:

• Blood cancers, such as leukemia or Hodgkin lymphoma
• Blood clots in the spleen or liver
• Certain types of anemia, a condition where you do not have enough healthy red blood cells
• Cystic fibrosis
• Infections such as mononucleosis, syphilis, malaria, and endocarditis
• Liver problems, including chronic liver damage (cirrhosis)
• Inherited metabolic disorders, such as Gaucher disease
• Inflammatory diseases, including sarcoidosis
• Protein disorders, like amyloidosis

Functional asplenia occurs when your spleen doesn’t work properly. It may be overactive and destroy healthy red blood cells. This can increase the risk of infection and cause bruising and bleeding. Functional asplenia may be caused by:

• An accident or trauma that damages the spleen
• Celiac disease
• Sickle cell disease

A damaged or ruptured spleen can result from car crashes and blows to the stomach area. This is a life-threatening injury that can cause severe internal bleeding.

Symptoms of Spleen Problems

An enlarged spleen often does not cause any signs or symptoms. Sometimes, people may notice the following:

• Pain or fullness in the left upper belly area that can spread to the left shoulder
• A feeling of fullness without eating, or only eating a small amount of food
• Anemia
• Frequent infections
• Bleeding easily

Symptoms of a ruptured spleen are generally more obvious:

• Pain in the upper left abdomen
• Tenderness when you touch the upper left abdomen
• Left shoulder pain
• Confusion, lightheadedness, or dizziness

Talk With Others Who Understand

On MyMSTeam, the social network for people with multiple sclerosis and their loved ones, more than 186,000 members come together to ask questions, give advice, and share their stories with others who understand life with multiple sclerosis.

Have you had spleen problems along with MS? Have you wondered whether they’re connected? Share your experience in the comments below, or start a conversation by posting on your Activities page.