Splenomegaly
Description | Enlargement due to increased functional activity of the spleen. Hyperplasia of the RES-system (for disposal of damaged erythrocytes) Differential diagnosis: Spherocytosis, hemoglobinopathy, paroxysmal nightly hemoglobinuria Evaluation: Hemolysis signs: Haptoglobin, reticulocytes, LDH, bilirubin Immune hyperplasia: Differential diagnosis: Infectious mononucleosis, HIV-infection, hepatitis B, hepatitis C, CMV, subacute endocarditis, connatal lues, tuberculosis, spleen abscess, malaria, leishmaniosis, trypanosomiasis Evaluation: Infectious serology or bacteriological cultures Differential diagnosis: Rheumatoid arthritis (Felty’s syndrome), SLE, vasculitides, immune hemolytic anemia, immune thrombocytopenia, medication reaction, sarcoidosis Evaluation: ANA, RF, ANCA, direct and indirect Coombs-test, thrombocyte antibodies and others Extra-medullary hematopoiesis: Differential diagnosis: Myelofibrosis, bone marrow damage, bone marrow infiltration caused by leukemia, tumor, M. Gaucher Evaluation: Blood count, bone marrow cytology and histology Enlargement due to decreased blood drain from spleen and portal vein system. Cirrhosis, congestive heart failure, portal vein obstruction, portal hypertension, hepatic vein obstruction, splenic vein obstruction, aneurysm of the splenic arteria, schistosomiasis, echinococcosis of the liver. Infiltration of the spleen: Intracellular or extracellular deposition: Amyloidosis, M. Gaucher, Niemann-Pick-disease, mucopolysaccharidosis and others Benign and malignant cellular infiltration: Leukemia (ALL, CML, CLL and others), lymphomas, M. Hodgkin, myeloproliferative illnesses, polycythemia vera, metastatic tumors (most commonly melanoma) and others Unknown etiology!
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