SPLENOMEGALY, CHRONIC

SPLENOMEGALY, CHRONIC: Excerpt from Algorithmic Diagnosis of Symptoms and Signs

Ask the Following Questions:

1. Is it massive? Massive splenomegaly is characteristic of Gaucher's disease, chronic myeloid leukemia, kala azar, and agnogenic myeloid metaplasia.
2. Is there jaundice? The presence of jaundice with massive splenomegaly would suggest chronic malaria. The presence of jaundice with mild to moderate splenomegaly would suggest alcoholic cirrhosis, chronic hepatitis, and hereditary spherocytosis.
3. Is there hepatomegaly? The presence of massive splenomegaly and hepatomegaly is characteristic of Gaucher's disease, chronic myeloid leukemia, kala azar, and agnogenic myeloid metaplasia.
4. Is there pallor? The presence of pallor, of course, suggests anemia and that would make one think of hereditary spherocytosis and other hemolytic anemias, collagen disease, and chronic malaria.
5. Is there lymphadenopathy? The presence of lymphadenopathy should make one think of chronic lymphatic leukemia, lymphomas, and sarcoidosis.

DIAGNOSTIC WORKUP

The diagnostic workup of chronic splenomegaly is similar to that for acute splenomegaly. A splenoportogram may be helpful in diagnosing portal vein thrombosis. Angiography may be helpful in diagnosing a splenic aneurysm. A liver biopsy, splenic aspiration and biopsy, and bone marrow biopsy may all be helpful in diagnosing the reticuloendothelioses such as Gaucher's disease.

Book Source Details

• Book Title: Algorithmic Diagnosis of Symptoms and Signs
• Author(s): R. Douglas Collins
• Year of Publication: 2003
• Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.

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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.

More About This Book: Title: Algorithmic Diagnosis of Symptoms and Signs Authors: R. Douglas Collins Publisher: Lippincott Williams & Wilkins Copyright: 2003 ISBN: 0-7817-3805-9

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