SPLENOMEGALY (2)

(classified according to size)

click here for a list of causes classified according to pathological cause

marked splenomegaly (>8cm):

common:

chronic myeloid leukaemia

myelofibrosis + myeloid metaplasia

less common:

visceral leishmaniasis

chronic malaria

rare:

Gaucher's disease

local cyst or tumour

moderate splenomegaly (4-8cm): any of above

Felty's syndrome (= RA + lymphadenopathy + hypersplenism)

lymphomas

chronic haemolytic anaemias and haemoglobinopathies / thalassaemias (esp. on low transfusion regimes)

polycythaemia rubra vera

congestion due to portal hypertension

amyloidosis

Langerhans cell histiocytosis

metastases (rare)

mild splenomegaly (<4cm): any of above

infective conditions, eg.subacute bacterial endocarditis, typhoid, brucellosis

connective tissue diseases, eg. systemic lupus erythematosus

idiopathic thrombocytopaenic purpura

sarcoidosis

acute leukaemias

megaloblastic anaemias

congestive heart failure / constrictive pericarditis

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