CAUSES OF SPLENOMEGALY:
A. CAUSES OF MASSIVE SPLENOMEGALY
- CHR MYELOGENOUS LEUKEMIA
- LYMPHOMAS
- HAIRY CELL LEUKEMIA
- MYELOFIBROSIS WITH MYELOID METAPLASIA
- POLYCYTHEMIA VERA
- GAUCHERS DISEASE
- CHR LYMPHOCYTIC LEUKEMIA
- SARCOIDOSIS
- AUTOIMMUNE HAEMOLYTIC ANEMIA
- DIFFUSE SPLENIC HAEMANGIOMATOSIS
B. CAUSES OF SPLENOMEGALY GROUPED BY PATHOGENIC MECHANISM
1. RETICULOENDOTHELIAL SYSTEM HYPERPLASIA
- SPHEROCYTOSIS
- EARLY SICKLE CELL ANEMIA
- OVALOCYTOSIS
- THALASSEMIA MAJOR
- HEMOGLOBINOPATHIES
- PAROXYSMAL NOCTURNAL HEMOGLOBINURIA
- MACROGLOBULINEMIA
- NUTRITIONAL ANEMIA
- ESSENTIAL THROMBOCYTHEMIA
2. IMMUNE HYPERPLASIA
* RESPONSE TO INFECTION ( VIRAL, BACTERIAL, FUNGAL, PARASITIC )
- INFECTIOUS MONONUCLEOSIS
- AIDS
- VIRAL HEPATITIS
- CYTOMEGALOVIRUS
- SUB ACUTE BACTERIAL ENDOCARDITIS
- BACTERIAL SEPTICEMIA
- CONGENITAL SYPHILIS
- SPLENIC ABSCESS
- TUBERCULOSIS
- HISTOPLASMOSIS
- MALARIA
- LEISHMANIASIS
-TRYPANOSOMIASIS
- EHRLICHIOSIS
* DISORDERED IMMUNOREGULATION
- RHEUMATOID ARTHRITIS ( FELTYS SYNDROME )
- SLE
- COLLAGEN VASCULAR DISEASES
- SERUM SICKNESS
- IMMUNE HEMOLYTIC ANEMIAS
- IMMUNE THROMBOCYTOPENIAS
- IMMUNE NEUTROPENIAS
- DRUG REACTIONS
- ANGIOIMMUNOBLASTIC LYMPHADENOPATHY
- SARCOIDOSIS
- THYROTOXICOSIS ( BENIGN LYMPHOID HYPERTROPHY )
- INTERLEUKIN-2 THERAPY
3. EXTRAMEDULLARY HEMATOPOIESIS
- MYELOFIBROSIS
- MARROW DAMAGE BY TOXINS, RADIATION , STRONTIUM
- MARROW INFILTRATION BY TUMORS , LEUKEMIAS, GAUCHER DISEASE
C. ENLARGEMENT DUE TO ABNORMAL SPLENIC OR PORTAL BLOOD FLOW
- CIRRHOSIS
- HEPATIC VEIN OBSTRUCTION
- PORTAL VEIN OBSTRUCTION
- CAVERNOUS TRANSFORMATION OF THE PORTAL VEIN
- SPLENIC VEIN OBSTRUCTION
- SPLENIC ARTRY ANEURYSM
- HEPATIC SCHISTOSOMIASIS
- CONGESTIVE HEART FAILURE
- HEPATIC ECHINOCOCCOSIS
- PORTAL HYPERTENSION ( ANY CAUSE INCLUDING THE ABOVE ) : BANTI DISEASE
- BUDD-CHIARI SYNDROME
D. INFILTRATION OF THE SPLEEN
1. INTRACELLULAR OR EXTRACELLULAR DEPOSITION
- AMYLOIDOSIS
- GAUCHERS DISEASE
- NIEMANN-PICK DISEASE
- TANGIER DISEASE
- HURLER SYNDROME & OTHER MUCOPOLYSACCHARIDOSES
- HYPERLIPIDEMIAS
2. BENIGN & MALIGNANT CELLULAR INFILTRATIONS
- LEUKEMIAS ( ACUTE , CHRONIC , LYMPHOID , MYELOID , MONOCYTIC )
- LYMPHOMAS
- HODGKINS DISEASE
- MYELOPROLIFERATIVE DISEASES LIKE POLYCYTHEMIA VERA
- ANGIOSARCOMAS
- METASTATIC TUMORS ( MELANOMA IS MOST COMMON )
- EOSINOPHILIC GRANULOMA
- HISTIOCYTOSIS X DISEASE
- HAMARTOMAS
- HEMANGIOMAS
- FIBROMAS
- LYMPHANGIOMAS
- SPLENIC CYSTS
- DERMOID CYST
E. UNKNOWN ETIOLOGY
- IDEOPATHIC SPLENOMEGALY
- BERYLLIOSIS
- IRON DEFICIENCY ANEMIA
OTHER TESTS :
* RBC COUNT : MAY BE
- NORMAL.
- DECREASED - THALASSEMAI MAJOR SYNDROMES, SLE, CIRRHOSIS WITH PORTAL HYPERTENSION.
- INCREASED - POLYCYTHEMIA VERA
* GRANULOCYTE COUNT - MAY BE
- NORMAL .
- DECREASED - FELTY SYNDROME , CONGESTIVE SPLENOMEGALY , LEUKEMIAS.
- INCREASED - INFECTIONS OR INFLAMMATORY DISEASE, MYELOPROLIFERATIVE DISEASES
* PLATELET COUNT MAY BE
- NORMAL
- DECREASED - DUE TO INCREASED DESTRUCTION IN ENLARGED SPLEEN ( CONGESTIVE SPLENOMEGALY , GAUCHERS DISEASE, IMMUNE THROMBOCYTOPENIA )
- INCREASED - MYELOPROLIFERATIVE DISORDERS LIKE POLYCYTHEMIA VERA
* COMPLETE BLOOD COUNT - CYTOPENIA OF ONE OR MORE BLOOD CELL TYPES