Splenomegaly: Difference between revisions
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! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Congestive | ! rowspan="3" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Congestive | ||
! colspan="2" align="center" style="background:#DCDCDC;" |[[Cirrhosis]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Cirrhosis]]<ref name="pmid22710653">{{cite journal |vauthors=Wu Z, Zhou J, Pankaj P, Peng B |title=Laparoscopic and open splenectomy for splenomegaly secondary to liver cirrhosis: an evaluation of immunity |journal=Surg Endosc |volume=26 |issue=12 |pages=3557–64 |date=December 2012 |pmid=22710653 |doi=10.1007/s00464-012-2366-5 |url=}}</ref> | ||
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* Infection | * Infection | ||
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* Dupuytren's contracture | * Dupuytren's contracture | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Congestive heart failure|Heart failure]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Congestive heart failure|Heart failure]]<ref name="pmid26489162">{{cite journal |vauthors=Gedela M, Khan M, Jonsson O |title=Heart Failure |journal=S D Med |volume=68 |issue=9 |pages=403–5, 407–9 |date=September 2015 |pmid=26489162 |doi= |url=}}</ref> | ||
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* Coronary artery disease | * Coronary artery disease | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Thrombosis]] of [[portal]], [[Liver|hepatic]], or [[Splenic vein|splenic veins]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Thrombosis]] of [[portal]], [[Liver|hepatic]], or [[Splenic vein|splenic veins]]<ref name="pmid22481689">{{cite journal |vauthors=Ferri PM, Ferreira AR, Fagundes ED, Liu SM, Roquete ML, Penna FJ |title=Portal vein thrombosis in children and adolescents: 20 years experience of a pediatric hepatology reference center |journal=Arq Gastroenterol |volume=49 |issue=1 |pages=69–76 |date=2012 |pmid=22481689 |doi= |url=}}</ref> | ||
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! rowspan="8" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Malignancy | ! rowspan="8" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Malignancy | ||
! colspan="2" align="center" style="background:#DCDCDC;" |[[Lymphoma]] | ! 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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! colspan="2" align="center" style="background:#DCDCDC;" |[[Leukemia]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Leukemia]]<ref name="pmid26614896">{{cite journal |vauthors=Quest GR, Johnston JB |title=Clinical features and diagnosis of hairy cell leukemia |journal=Best Pract Res Clin Haematol |volume=28 |issue=4 |pages=180–92 |date=December 2015 |pmid=26614896 |doi=10.1016/j.beha.2015.10.017 |url=}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Polycythemia vera|Polycythemia Vera]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Polycythemia vera|Polycythemia Vera]]<ref name="pmid23281576">{{cite journal |vauthors=Chou YS, Gau JP, Yu YB, Pai JT, Hsiao LT, Liu JH, Hong YC, Liu CY, Yang CF, Chen PM, Chiou TJ, Tzeng CH |title=Leukocytosis in polycythemia vera and splenomegaly in essential thrombocythemia are independent risk factors for hemorrhage |journal=Eur. J. Haematol. |volume=90 |issue=3 |pages=228–36 |date=March 2013 |pmid=23281576 |doi=10.1111/ejh.12064 |url=}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Multiple myeloma]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Multiple myeloma]]<ref name="pmid3400674">{{cite journal |vauthors=Grieco A, Manna R, Mancini R, Gambassi G |title=Massive hepatomegaly following splenectomy for myeloid metaplasia |journal=Am. J. Med. |volume=84 |issue=4 |pages=797 |date=April 1988 |pmid=3400674 |doi= |url=}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Essential thrombocytosis|Essential thrombocythemia]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Essential thrombocytosis|Essential thrombocythemia]]<ref name="pmid25611051">{{cite journal |vauthors=Tefferi A, Barbui T |title=Polycythemia vera and essential thrombocythemia: 2015 update on diagnosis, risk-stratification and management |journal=Am. J. Hematol. |volume=90 |issue=2 |pages=162–73 |date=February 2015 |pmid=25611051 |doi=10.1002/ajh.23895 |url=}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Myelofibrosis|Primary myelofibrosis]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Myelofibrosis|Primary myelofibrosis]]<ref name="pmid23514013">{{cite journal |vauthors=Cervantes F, Martinez-Trillos A |title=Myelofibrosis: an update on current pharmacotherapy and future directions |journal=Expert Opin Pharmacother |volume=14 |issue=7 |pages=873–84 |date=May 2013 |pmid=23514013 |doi=10.1517/14656566.2013.783019 |url=}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Splenic tumor|Primary splenic tumors]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Splenic tumor|Primary splenic tumors]]<ref name="pmid21810495">{{cite journal |vauthors=Adachi K, Ui M, Nojima H, Takada Y, Enatsu K |title=Isolated splenic peliosis presenting with giant splenomegaly and severe coagulopathy |journal=Am. J. Surg. |volume=202 |issue=2 |pages=e17–9 |date=August 2011 |pmid=21810495 |doi=10.1016/j.amjsurg.2010.10.002 |url=}}</ref> | ||
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! colspan="2" align="center" style="background:#DCDCDC;" |[[Metastasis|Metastatic solid tumors]] | ! colspan="2" align="center" style="background:#DCDCDC;" |[[Metastasis|Metastatic solid tumors]]<ref name="pmid24172780">{{cite journal |vauthors=Huprikar NA, Kurtz MT, Mount CA |title=Massive splenomegaly and lymphopenia: a unique case of obstructive shock |journal=BMJ Case Rep |volume=2013 |issue= |pages= |date=October 2013 |pmid=24172780 |pmc=3822246 |doi=10.1136/bcr-2013-201643 |url=}}</ref> | ||
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! rowspan="6" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infiltrative | ! rowspan="6" style="background: #4479BA; color: #FFFFFF; text-align: center;" |Infiltrative | ||
! colspan="2" align="center" style="background:#DCDCDC;" |[[Gaucher's disease|Gaucher disease]] | ! 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 19:25, 27 September 2018
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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 | ↑ | ↑ | ↑ | Dark urine |
|
|
Liver biopsy |
| ||
Heart failure[2] |
|
Elderly |
|
– | + | ↑↓ | – | – | ↑ | ↑ | ± | + |
|
↓ | ↓ | ↑ | Nl | ↑ | ↑ | ↑ | Nl | NA |
|
Echocardiography |
| ||
Thrombosis of portal, hepatic, or splenic veins[3] | |||||||||||||||||||||||||||
Malignancy | Lymphoma[4] | ||||||||||||||||||||||||||
Leukemia[5] | |||||||||||||||||||||||||||
Polycythemia Vera[6] | |||||||||||||||||||||||||||
Multiple myeloma[7] | |||||||||||||||||||||||||||
Essential thrombocythemia[8] | |||||||||||||||||||||||||||
Primary myelofibrosis[9] | |||||||||||||||||||||||||||
Primary splenic tumors[10] | |||||||||||||||||||||||||||
Metastatic solid tumors[11] | |||||||||||||||||||||||||||
Category | 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 | |
Infection | Viral | Hepatitis | |||||||||||||||||||||||||
Infectious mononucleosis | |||||||||||||||||||||||||||
Cytomegalovirus | |||||||||||||||||||||||||||
Bacterial | Salmonella | ||||||||||||||||||||||||||
Brucella | |||||||||||||||||||||||||||
Tuberculosis | |||||||||||||||||||||||||||
Parasitic | Malaria | ||||||||||||||||||||||||||
Schistosomiasis | |||||||||||||||||||||||||||
Toxoplasmosis | |||||||||||||||||||||||||||
Kala-azar | Visceral leishmaniasis | ||||||||||||||||||||||||||
Infective endocarditis | |||||||||||||||||||||||||||
Fungal | |||||||||||||||||||||||||||
Inflammation | Sarcoidosis | ||||||||||||||||||||||||||
Serum sickness | |||||||||||||||||||||||||||
Systemic lupus erythematosus | |||||||||||||||||||||||||||
Felty syndrome | |||||||||||||||||||||||||||
Category | 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 | |
Infiltrative | Gaucher disease[12] | ||||||||||||||||||||||||||
Niemann-Pick disease | |||||||||||||||||||||||||||
Amyloidosis | |||||||||||||||||||||||||||
Langerhans cell histiocytosis | |||||||||||||||||||||||||||
Hemophagocytic lymphohistiocytosis | |||||||||||||||||||||||||||
Rosai-Dorfman disease | |||||||||||||||||||||||||||
Hematologic (hypersplenic) states | Hemolytic anemia | ||||||||||||||||||||||||||
Sickle cell disease | |||||||||||||||||||||||||||
Granulocyte colony-stimulating factor | |||||||||||||||||||||||||||
Category | 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
Related Chapters
References
- ↑ 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.
- ↑ Gedela M, Khan M, Jonsson O (September 2015). "Heart Failure". S D Med. 68 (9): 403–5, 407–9. PMID 26489162.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ 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.
- ↑ Ayto R, Hughes DA (2013). "Gaucher disease and myeloma". Crit Rev Oncog. 18 (3): 247–68. PMID 23510067.