Destruction of red blood cells mainly occurs when the red blood cells circulate through the narrow capillaries of the spleen. Only the most flexible and supple red blood cells will be able to flow through the spleen. Even with the smallest abnormality, the red blood cells won’t be able to twist themselves through the spleen and will be destroyed.

Patients with hemolytic anemia have a higher amount of damaged red blood cells. These will get entangled and destroyed in the spleen. To compensate this higher workload, the spleen will expand.  An enlarged spleen (also called splenomegaly) is very typical for patients with hemolytic anemia. Mostly, the swelling is not very severe, but in some cases the patient can have an enormous spleen. This can cause a vague feeling of oppression in the left side of the belly. Sometimes, it can also cause abdominal pain.

“I still have my spleen but it is enlarged and my doctor says I most probably have to have a splenectomy in the future”
Female, 29 years

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