Splenomegaly: Difference between revisions

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* [[Esophageal varices]]
* [[Esophageal varices]]
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! rowspan="9" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Malignancy
! rowspan="10" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Malignancy
! colspan="2" align="center" style="background:#DCDCDC;" |[[Lymphoma]]<ref name="pmid25131182">{{cite journal |vauthors=Ishibashi N, Maebayashi T, Aizawa T, Sakaguchi M, Abe O, Saito T, Tanaka Y |title=Myelosuppression toxicity of palliative splenic irradiation in myelofibrosis and malignant lymphoma |journal=Hematology |volume=20 |issue=4 |pages=203–7 |date=May 2015 |pmid=25131182 |doi=10.1179/1607845414Y.0000000192 |url=}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" |[[Lymphoma]]<ref name="pmid25131182">{{cite journal |vauthors=Ishibashi N, Maebayashi T, Aizawa T, Sakaguchi M, Abe O, Saito T, Tanaka Y |title=Myelosuppression toxicity of palliative splenic irradiation in myelofibrosis and malignant lymphoma |journal=Hematology |volume=20 |issue=4 |pages=203–7 |date=May 2015 |pmid=25131182 |doi=10.1179/1607845414Y.0000000192 |url=}}</ref>
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* [[Disseminated intravascular coagulation|DIC]]
* [[Disseminated intravascular coagulation|DIC]]
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
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! rowspan="13" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infection
! rowspan="13" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infection
! rowspan="3" align="center" style="background:#DCDCDC;" |[[Virus|Viral]]
! rowspan="3" align="center" style="background:#DCDCDC;" |[[Virus|Viral]]
! align="center" style="background:#DCDCDC;" |[[Hepatitis]]
! align="center" style="background:#DCDCDC;" |[[Hepatitis]]<ref name="pmid23904062">{{cite journal |vauthors=Kumar KJ, Kumar HC, Manjunath VG, Anitha C, Mamatha S |title=Hepatitis A in children- clinical course, complications and laboratory profile |journal=Indian J Pediatr |volume=81 |issue=1 |pages=15–9 |date=January 2014 |pmid=23904062 |doi=10.1007/s12098-013-1114-8 |url=}}</ref>
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* Infection
* Infection
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* [[Encephalomyelitis]]
* [[Encephalomyelitis]]
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! align="center" style="background:#DCDCDC;" |[[Mononucleosis|Infectious mononucleosis]]
! align="center" style="background:#DCDCDC;" |[[Mononucleosis|Infectious mononucleosis]]<ref name="pmid21191775">{{cite journal |vauthors=Gao LW, Xie ZD, Liu YY, Wang Y, Shen KL |title=Epidemiologic and clinical characteristics of infectious mononucleosis associated with Epstein-Barr virus infection in children in Beijing, China |journal=World J Pediatr |volume=7 |issue=1 |pages=45–9 |date=February 2011 |pmid=21191775 |doi=10.1007/s12519-011-0244-1 |url=}}</ref>
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* EBV
* EBV
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|-
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! align="center" style="background:#DCDCDC;" |[[Cytomegalovirus]]
! align="center" style="background:#DCDCDC;" |[[Cytomegalovirus]]<ref name="pmid25308607">{{cite journal |vauthors=Smiechura M, Strużycka M, Konopka W |title=Congenital and acquired cytomegalovirus infection and hearing evaluation in children |journal=Otolaryngol Pol |volume=68 |issue=6 |pages=303–7 |date=2014 |pmid=25308607 |doi=10.1016/j.otpol.2014.04.003 |url=}}</ref>
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! rowspan="3" align="center" style="background:#DCDCDC;" |[[Bacteria|Bacterial]]
! rowspan="3" align="center" style="background:#DCDCDC;" |[[Bacteria|Bacterial]]
! align="center" style="background:#DCDCDC;" |[[Salmonella]]
! align="center" style="background:#DCDCDC;" |[[Salmonella]]<ref name="pmid26068006">{{cite journal |vauthors=Rosche KL, Aljasham AT, Kipfer JN, Piatkowski BT, Konjufca V |title=Infection with Salmonella enterica Serovar Typhimurium Leads to Increased Proportions of F4/80+ Red Pulp Macrophages and Decreased Proportions of B and T Lymphocytes in the Spleen |journal=PLoS ONE |volume=10 |issue=6 |pages=e0130092 |date=2015 |pmid=26068006 |pmc=4466801 |doi=10.1371/journal.pone.0130092 |url=}}</ref>
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! align="center" style="background:#DCDCDC;" |[[Brucella]]
! align="center" style="background:#DCDCDC;" |[[Brucella]]<ref name="pmid24983999">{{cite journal |vauthors=Roset MS, Ibañez AE, de Souza Filho JA, Spera JM, Minatel L, Oliveira SC, Giambartolomei GH, Cassataro J, Briones G |title=Brucella cyclic β-1,2-glucan plays a critical role in the induction of splenomegaly in mice |journal=PLoS ONE |volume=9 |issue=7 |pages=e101279 |date=2014 |pmid=24983999 |pmc=4077732 |doi=10.1371/journal.pone.0101279 |url=}}</ref>
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! align="center" style="background:#DCDCDC;" |[[Tuberculosis]]
! align="center" style="background:#DCDCDC;" |[[Tuberculosis]]<ref name="pmid27051579">{{cite journal |vauthors=Chandni R, Chandni R, Chandni R |title=Extra pulmonary tuberculosis presenting as fever with massive splenomegaly and pancytopenia |journal=IDCases |volume=4 |issue= |pages=20–2 |date=2016 |pmid=27051579 |pmc=4802818 |doi=10.1016/j.idcr.2016.02.005 |url=}}</ref>
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! rowspan="4" align="center" style="background:#DCDCDC;" |[[Parasitism|Parasitic]]  
! rowspan="4" align="center" style="background:#DCDCDC;" |[[Parasitism|Parasitic]]  
! align="center" style="background:#DCDCDC;" |[[Malaria]]
! align="center" style="background:#DCDCDC;" |[[Malaria]]<ref name="pmid26612502">{{cite journal |vauthors=Sumbele IU, Bopda OS, Kimbi HK, Ning TR, Nkuo-Akenji T |title=Influence of Plasmodium gametocyte carriage on the prevalence of fever, splenomegaly and cardiovascular parameters in children less than 15 years in the Mount Cameroon area: cross sectional study |journal=BMC Infect. Dis. |volume=15 |issue= |pages=547 |date=November 2015 |pmid=26612502 |pmc=4661959 |doi=10.1186/s12879-015-1290-4 |url=}}</ref>
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! align="center" style="background:#DCDCDC;" |[[Schistosomiasis]]
! align="center" style="background:#DCDCDC;" |[[Schistosomiasis]]<ref name="pmid25434143">{{cite journal |vauthors=Pan J, Liu L, Yan YH, Shao ZW, Li Q, Zhou RH |title=[Application of health education path in advanced schistosomiasis patients with splenomegaly in perioperative period] |language=Chinese |journal=Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi |volume=26 |issue=4 |pages=425–7, 430 |date=August 2014 |pmid=25434143 |doi= |url=}}</ref>
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|-
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! align="center" style="background:#DCDCDC;" |[[Toxoplasmosis]]
! align="center" style="background:#DCDCDC;" |[[Toxoplasmosis]]<ref name="pmid25210646">{{cite journal |vauthors=Oz HS |title=Novel Synergistic Protective Efficacy of Atovaquone and Diclazuril on Fetal-Maternal Toxoplasmosis |journal=Int J Clin Med |volume=5 |issue=15 |pages=921–932 |date=August 2014 |pmid=25210646 |pmc=4157831 |doi= |url=}}</ref>
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! align="center" style="background:#DCDCDC;" |[[Visceral leishmaniasis|Kala-azar]]
! align="center" style="background:#DCDCDC;" |[[Visceral leishmaniasis|Kala-azar]]<ref name="pmid24850963">{{cite journal |vauthors=Sayyahfar S, Ansari S, Mohebali M, Behnam B |title=Visceral leishmaniasis without fever in an 11-month-old infant: a rare clinical feature of Kala-azar |journal=Korean J. Parasitol. |volume=52 |issue=2 |pages=189–91 |date=April 2014 |pmid=24850963 |pmc=4028457 |doi=10.3347/kjp.2014.52.2.189 |url=}}</ref>
| align="center" style="background:#F5F5F5;" |[[Visceral leishmaniasis]]
| align="center" style="background:#F5F5F5;" |[[Visceral leishmaniasis]]
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Endocarditis|Infective endocarditis]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Endocarditis|Infective endocarditis]]<ref name="pmid25352503">{{cite journal |vauthors=Francischetto O, Silva LA, Senna KM, Vasques MR, Barbosa GF, Weksler C, Ramos RG, Golebiovski WF, Lamas Cda C |title=Healthcare-associated infective endocarditis: a case series in a referral hospital from 2006 to 2011 |journal=Arq. Bras. Cardiol. |volume=103 |issue=4 |pages=292–8 |date=October 2014 |pmid=25352503 |pmc=4206359 |doi= |url=}}</ref>
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Fungus|Fungal]]
! colspan="2" align="center" style="background:#DCDCDC;" |[[Fungus|Fungal]]<ref name="pmid23118473">{{cite journal |vauthors=Balakrishnan N, Jawanda JS, Miller MB, Breitschwerdt EB |title=Bartonella henselae infection in a man with hypergammaglobulinaemia, splenomegaly and polyclonal plasmacytosis |journal=J. Med. Microbiol. |volume=62 |issue=Pt 2 |pages=338–41 |date=February 2013 |pmid=23118473 |doi=10.1099/jmm.0.052134-0 |url=}}</ref>
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* [[Infection|Infections]]
* [[Infection|Infections]]
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Category
! rowspan="7" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infiltrative
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
! colspan="2" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Disease
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Etiology
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! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
! style="background: #4479BA; color: #FFFFFF; text-align: center;" |Associated findings
|-
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! rowspan="6" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infiltrative
! colspan="2" align="center" style="background:#DCDCDC;" |[[Gaucher's disease|Gaucher disease]]<ref name="pmid23510067">{{cite journal |vauthors=Ayto R, Hughes DA |title=Gaucher disease and myeloma |journal=Crit Rev Oncog |volume=18 |issue=3 |pages=247–68 |date=2013 |pmid=23510067 |doi= |url=}}</ref>
! colspan="2" align="center" style="background:#DCDCDC;" |[[Gaucher's disease|Gaucher disease]]<ref name="pmid23510067">{{cite journal |vauthors=Ayto R, Hughes DA |title=Gaucher disease and myeloma |journal=Crit Rev Oncog |volume=18 |issue=3 |pages=247–68 |date=2013 |pmid=23510067 |doi= |url=}}</ref>
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Revision as of 00:02, 30 September 2018

WikiDoc Resources for Splenomegaly

Articles

Most recent articles on Splenomegaly

Most cited articles on Splenomegaly

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Guidelines / Policies / Govt

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Causes & Risk Factors for Splenomegaly

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Experimental / Informatics

List of terms related to Splenomegaly

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: ; Gichoya Judy Wawira [2], Moi University School of Medicine

Synonyms and keywords: Spleen enlargement; enlarged spleen; spleen swelling

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Splenomegaly from Other Diseases

Category Disease Etiology Clinical manifestations Para−clinical findings Gold standard Associated findings
Demography History Symptoms Signs Lab Findings Imaging
Fever Fatigue Weight Abdominal pain Bleeding BP JVP Jaundice Ascites Other CBC Iron LFT PT/PTT BUN/Cr UA Histopathology
WBC Hb Plt
Congestive Cirrhosis[1] Any, more in elderly + ↑↓ + + Nl + + Nl Liver biopsy
Heart failure[2] Elderly + ↑↓ ± + Nl Nl NA Echocardiography
Thrombosis of portal, hepatic, or splenic veins[3] Any + + + + Nl ± + Nl NA Doppler ultrasonography
Malignancy Lymphoma[4] Any, most common malignant splenic tumor + + + + Nl Nl + High ferritin Nl Lymph node biopsy
Leukemia[5] Elderly, male>female + + + + Nl Nl ± + High ferritin Nl
  • Leukemic blasts
  • Leukoerythroblastic features
  • Giant platelets
NA Bone marrow examination + clinical manifestation
Polycythemia Vera[6] Mean age >60 years old
  • Positive family history
+ Nl + Nl Nl Nl to ↑ Nl to ↑ High ferritin Nl Nl Nl Nl
  • Elevated normochromic, normocytic RBCs
  • Thrombocytosis
  • Rarely immature cells
  • Leukoerythroblastic picture
NA WHO criteria for PV
Disease Etiology Demography History Fever Fatigue Weight loss Abdominal pain Bleeding BP JVP Jaundice Ascites Other WBC Hb Plt Iron LFT PT/PTT BUN/Cr UA Histopathology Imaging Gold standard Associated findings
Multiple myeloma[7] Any, more in adults + + + + Nl Nl + High ferritin Nl
  • Blast cells
Bone marrow examination
Essential thrombocythemia[8]
  • Acquired mutation of JAK2, CALR, or MPL
Mean age >60 years old, female > male ± + Nl + + Nl Nl ↑↑ Nl Nl Nl Nl Nl Bone marrow biopsy
Primary myelofibrosis[9] Mean age >60 years old, male> female + Nl + + Nl Nl + ↑/↓ Low iron Nl Nl Bone marrow biopsy
Primary splenic tumors[10] Rare
Metastatic solid tumors[11] Any, more in adults + + + + Nl ± ± Low iron, high ferritin
  • Blast cells
Biopsy
Disease Etiology Demography History Fever Fatigue Weight Abdominal pain Bleeding BP JVP Jaundice Ascites Other WBC Hb Plt Iron LFT PT/PTT BUN/Cr UA Histopathology Imaging Gold standard Associated findings
Infection Viral Hepatitis[12]
  • Infection
  • Autoimmune
Any
  • High risk behaviors
  • Close contact
+ + + + Nl Nl + + Nl Clinical manifestation + lab tests
Infectious mononucleosis[13]
  • EBV
Cytomegalovirus[14]
Bacterial Salmonella[15]
Brucella[16]
Tuberculosis[17]
Parasitic Malaria[18]
Schistosomiasis[19]
Toxoplasmosis[20]
Kala-azar[21] Visceral leishmaniasis
Infective endocarditis[22]
Fungal[23]
Disease Etiology Demography History Fever Fatigue Weight loss Abdominal pain Bleeding BP JVP Jaundice Ascites Other WBC Hb Plt Iron LFT PT/PTT BUN/Cr UA Histopathology Imaging Gold standard Associated findings
Inflammation Sarcoidosis Autoimmune disease, more in young African American women
  • Positive family history
+ + + + Nl Nl - - Nl Nl Nl Nl Nl NA Diagnosis of exclusion
Serum sickness
Systemic lupus erythematosus More in young females
  • Family history
+ + + + Nl to ↓ Nl + + Clinical findings + laboratory studies
  • Multi organ damage
Felty syndrome Rare autoimmune disease, more in females 50-70 years old + + + + Nl to ↓ Nl + + Nl Nl Nl Nl Nl Clinical findings + laboratory studies
Infiltrative Disease Etiology Demography History Fever Fatigue Weight loss Abdominal pain Bleeding BP JVP Jaundice Ascites Other WBC Hb Plt Iron LFT PT/PTT BUN/Cr UA Histopathology Imaging Gold standard Associated findings
Gaucher disease[24] Rare, mostly in children
  • Family history
- + + + Nl to ↓ Nl + + Nl Nl Clinical findings + laboratory studies
Niemann-Pick disease
Amyloidosis
Langerhans cell histiocytosis
Hemophagocytic lymphohistiocytosis
Rosai-Dorfman disease
Hematologic (hypersplenic) states Hemolytic anemia
Sickle cell disease
Granulocyte colony-stimulating factor
Disease Etiology Demography History Fever Fatigue Weight loss Abdominal pain Bleeding BP JVP Jaundice Ascites Other WBC Hb Plt Iron LFT PT/PTT BUN/Cr UA Histopathology Imaging Gold standard Associated findings

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications, and Prognosis

Diagnosis

Treatment

Case Studies

Case #1

Related Chapters

References

  1. Wu Z, Zhou J, Pankaj P, Peng B (December 2012). "Laparoscopic and open splenectomy for splenomegaly secondary to liver cirrhosis: an evaluation of immunity". Surg Endosc. 26 (12): 3557–64. doi:10.1007/s00464-012-2366-5. PMID 22710653.
  2. Gedela M, Khan M, Jonsson O (September 2015). "Heart Failure". S D Med. 68 (9): 403–5, 407–9. PMID 26489162.
  3. Ferri PM, Ferreira AR, Fagundes ED, Liu SM, Roquete ML, Penna FJ (2012). "Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center". Arq Gastroenterol. 49 (1): 69–76. PMID 22481689.
  4. Ishibashi N, Maebayashi T, Aizawa T, Sakaguchi M, Abe O, Saito T, Tanaka Y (May 2015). "Myelosuppression toxicity of palliative splenic irradiation in myelofibrosis and malignant lymphoma". Hematology. 20 (4): 203–7. doi:10.1179/1607845414Y.0000000192. PMID 25131182.
  5. Quest GR, Johnston JB (December 2015). "Clinical features and diagnosis of hairy cell leukemia". Best Pract Res Clin Haematol. 28 (4): 180–92. doi:10.1016/j.beha.2015.10.017. PMID 26614896.
  6. Chou YS, Gau JP, Yu YB, Pai JT, Hsiao LT, Liu JH, Hong YC, Liu CY, Yang CF, Chen PM, Chiou TJ, Tzeng CH (March 2013). "Leukocytosis in polycythemia vera and splenomegaly in essential thrombocythemia are independent risk factors for hemorrhage". Eur. J. Haematol. 90 (3): 228–36. doi:10.1111/ejh.12064. PMID 23281576.
  7. Grieco A, Manna R, Mancini R, Gambassi G (April 1988). "Massive hepatomegaly following splenectomy for myeloid metaplasia". Am. J. Med. 84 (4): 797. PMID 3400674.
  8. Tefferi A, Barbui T (February 2015). "Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management". Am. J. Hematol. 90 (2): 162–73. doi:10.1002/ajh.23895. PMID 25611051.
  9. Cervantes F, Martinez-Trillos A (May 2013). "Myelofibrosis: an update on current pharmacotherapy and future directions". Expert Opin Pharmacother. 14 (7): 873–84. doi:10.1517/14656566.2013.783019. PMID 23514013.
  10. Adachi K, Ui M, Nojima H, Takada Y, Enatsu K (August 2011). "Isolated splenic peliosis presenting with giant splenomegaly and severe coagulopathy". Am. J. Surg. 202 (2): e17–9. doi:10.1016/j.amjsurg.2010.10.002. PMID 21810495.
  11. Huprikar NA, Kurtz MT, Mount CA (October 2013). "Massive splenomegaly and lymphopenia: a unique case of obstructive shock". BMJ Case Rep. 2013. doi:10.1136/bcr-2013-201643. PMC 3822246. PMID 24172780.
  12. Kumar KJ, Kumar HC, Manjunath VG, Anitha C, Mamatha S (January 2014). "Hepatitis A in children- clinical course, complications and laboratory profile". Indian J Pediatr. 81 (1): 15–9. doi:10.1007/s12098-013-1114-8. PMID 23904062.
  13. Gao LW, Xie ZD, Liu YY, Wang Y, Shen KL (February 2011). "Epidemiologic and clinical characteristics of infectious mononucleosis associated with Epstein-Barr virus infection in children in Beijing, China". World J Pediatr. 7 (1): 45–9. doi:10.1007/s12519-011-0244-1. PMID 21191775.
  14. Smiechura M, Strużycka M, Konopka W (2014). "Congenital and acquired cytomegalovirus infection and hearing evaluation in children". Otolaryngol Pol. 68 (6): 303–7. doi:10.1016/j.otpol.2014.04.003. PMID 25308607.
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