Splenomegaly causes: Difference between revisions

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__NOTOC__
__NOTOC__
{{Splenomegaly}}
{{Splenomegaly}}
{{CMG}}; {{AE}} {{VSKP}}
{{CMG}}; {{AE}} {{VSKP}}


==Overview==
==Overview==
The causes of splenomegaly vary widely and range from infections, congestion due to increased blood flow, [[Cirrhosis]] and other liver diseases, infiltration of the spleen from other diseases like [[Leukemia]], [[Lymphoma]] and storage disorders, inflammatory conditions like [[Sarcoidosis]] and [[Lupus]], blood cell diseases and Malignancies.
The causes of splenomegaly vary widely and range from increased splenic function (such as [[hemoglobinopathies]]), splenic congestion due to abnormal blood flow (such as venous obstruction), and splenic infiltration (such as storage disorders and [[malignancies]]).


==Causes==
==Causes==
===Causes by Pathogenesis===
{| class="wikitable"
|-
! Increased function
! Abnormal blood flow
! Infiltration
|-
| valign = top | '''''Removal of defective RBCs'''''
[[Spherocytosis]]<br />
[[Thalassemia]]<br />
[[Hemoglobinopathies]]<br />
[[Anemia|Nutritional anemia]]s<br />
[[sickle cell anemia]]<br />
'''''Immune hyperplasia'''''<br />
''Response to infection (viral,bacterial,fungal,parasitic'')<br />[[Mononucleosis]], [[AIDS]], [[Viral hepatitis]]<br />[[Endocarditis|Subacute bacterial endocarditis]], [[Sepsis|Bacterial septicemia]]<br/> [[Splenic abscess]], [[Typhoid fever]]<br />[[brucellosis]],[[Leptospirosis]], [[tuberculosis]]<br />[[Histoplasmosis]]<br />[[Malaria]], [[leishmaniasis]], [[trypanosomiasis]]<br />[[Ehrlichiosis]]<br />''Disordered immunoregulation''<br />[[Rheumatoid arthritis]]<br />[[SLE]]<br />[[Serum sickness]]<br />[[Autoimmune hemolytic anemia]]<br />[[Idiopathic thrombocytopenic purpura|Immune thrombocytopenia]]<br />[[Sarcoidosis]]<br />Drug reactions<br />'''''Extramedullary hematopoiesis'''''<br />[[Myelofibrosis]]<br />[[Marrow infiltration by tumors, leukemias]]<br />[[marrow damage by radiation, toxins]]
| valign = top | '''''Organ Failure'''''<br />
[[Cirrhosis]]<br />[[congestive heart failure]]<br />'''''Vascular'''''<br />[[Hepatic vein obstruction]]<br />[[Portal vein thrombosis|Portal vein obstruction]]<br />[[Budd-Chiari syndrome]]<br />[[Splenic vein obstruction]]<br />'''''Infections'''''<br />Hepatic [[schistosomiasis]]<br />Hepatic [[echinococcosis]]
| valign = top | '''''Metabolic diseases'''''<br />[[Gauchers disease]]<br />[[Niemann-Pick disease]]<br />[[Hurler syndrome]] and other [[Mucopolysaccharidoses]]<br />[[Amyloidosis]]<br />[[Tangier disease]]<br />'''''Benign and malignant infiltrations'''''<br />[[Leukemias]]([[acute]], [[chronic]], [[lymphoid]] and [[myeloid]])<br />[[Lymphomas]] ([[Hodgkins]] and [[Non-Hodgkin lymphoma|non-hodgkins]])<br />[[Myeloproliferative]] disorders<br />[[Metastatic]] tumors(commonly [[melanoma]])<br />[[Histiocytosis X]]<br />[[Hemangioma]],[[Lymphangioma]]<br />[[Splenic cyst]]<br />[[Hamartomas]]<br />[[Eosinophilic granuloma]]
|}
===Causes of Massive Splenomegaly (>1000 gms)===
*[[Autoimmune hemolytic anemia]]
*[[Chronic lymphocytic leukemia]]
*[[Chronic myelogenous leukemia]]
*[[Gauchers disease]]
*[[Hairy cell leukemia]]
*[[Kala-Azar]] ([[Leishmaniasis]])
*[[Lymphomas]]
*[[Malaria]]
*[[Myelofibrosis]]
*[[Polycythemia vera]]
*[[Portal hypertension]] of Bilharziasis
*[[Sarcoidosis]]
*[[Thalassemia]]


===Common causes of Splenomegaly===
===Common Causes===  
*[[Bacterial endocarditis]]
*[[Bacterial endocarditis]]
*[[Infectious mononucleosis]]
*[[Infectious mononucleosis]]
Line 59: Line 22:
*[[Spherocytosis]]
*[[Spherocytosis]]
*[[Thalassemia]]
*[[Thalassemia]]
===Less Common Causes <ref>Kahan, Scott, Smith, Ellen G. In a page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:157</ref>===
===Less Common Causes <ref>Kahan, Scott, Smith, Ellen G. In a page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:157</ref>===
*[[Amyloidosis]]
*[[Amyloidosis]]
Line 69: Line 28:
*[[Histoplasmosis]]
*[[Histoplasmosis]]
*[[Kala-azar]]
*[[Kala-azar]]
*[[Rickets]]
[[Rickets]]
*[[Schistosomiasis]]
*[[Schistosomiasis]]
*[[Syphilis]]
*[[Syphilis]]
*[[Toxoplasmosis]]
*[[Toxoplasmosis]]
*[[Typhoid fever]]
*[[Typhoid fever]]
===Causes by Pathogenesis===
{| class="wikitable"
|-
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Mechanism
! colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Pathogenesis
! align="center" style="background:#4479BA; color: #FFFFFF;" + |Example
|-
! rowspan="5" align="center" style="background:#4479BA; color: #FFFFFF;" + |Increased function
! colspan="2" |Removal of defective RBCs
| <div style="-moz-column-count:2; column-count:2;">
* [[Spherocytosis]]
* [[Thalassemia]]
* [[Hemoglobinopathy]]
* [[Anemia]]
* [[Sickle cell anemia]]
</div>
|-
! rowspan="3" |Immune hyperplasia
!Response to infection (viral, bacterial, fungal, parasitic)
| <div style="-moz-column-count:2; column-count:2;">
* [[Mononucleosis]]
* [[AIDS]]
* [[Viral hepatitis]]
* [[Endocarditis|Subacute bacterial endocarditis]]
* [[Sepsis|Bacterial septicemia]]
* [[Splenic abscess]]
* [[Typhoid fever]]
* [[Leptospirosis]]
* [[Tuberculosis]]
* [[Histoplasmosis]]
* [[Malaria]]
* [[leishmaniasis]]
* [[Trypanosomiasis]]
* [[Ehrlichiosis]]
</div>
|-
!Disordered immunoregulation
| <div style="-moz-column-count:2; column-count:2;">
* [[Rheumatoid arthritis]]
* [[SLE]]
* [[Serum sickness]]
* [[Autoimmune hemolytic anemia]]
* [[Idiopathic thrombocytopenic purpura|Immune thrombocytopenia]]
* [[Sarcoidosis]]
</div>
|-
!Drug reactions
|
* [[Cidofovir]]
* [[Filgrastim]]
|-
! colspan="2" |Extramedullary hematopoiesis
| <div style="-moz-column-count:2; column-count:2;">
* [[Myelofibrosis]]
* [[Tumors]]
* [[Marrow infiltration by tumors, leukemias|Lukemias]]
* [[marrow damage by radiation, toxins|Marrow damage by radiation]]
* [[marrow damage by radiation, toxins|toxins]]
</div>
|-
! rowspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" + |Abnormal blood flow
! colspan="2" |Organ Failure
|
* [[Cirrhosis]]
* [[Congestive heart failure]]
|-
! colspan="2" |Vascular
| <div style="-moz-column-count:2; column-count:2;">
* [[Hepatic vein obstruction]]
* [[Portal vein thrombosis|Portal vein obstruction]]
* [[Budd-Chiari syndrome]]
* Splenic vein obstruction
</div>
|-
! colspan="2" |Infections
|
* Hepatic [[schistosomiasis]]
* Hepatic [[echinococcosis]]
|-
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" + |Infiltration
! colspan="2" |Metabolic diseases
| <div style="-moz-column-count:2; column-count:2;">
* [[Gauchers disease]]
* [[Niemann-Pick disease]]
* [[Hurler syndrome]]
* [[Mucopolysaccharidoses]]
* [[Amyloidosis]]
* [[Tangier disease]]
</div>
|-
! colspan="2" |Benign and malignant infiltrations
| <div style="-moz-column-count:2; column-count:2;">
* [[Leukemias]] ([[acute]], [[chronic]], [[lymphoid]] and [[myeloid]])
* [[Lymphomas]] ([[Hodgkins]] and [[Non-Hodgkin lymphoma|non-hodgkins]])
* [[Myeloproliferative]] disorders
* [[Metastatic]] tumors (commonly [[melanoma]])
* [[Histiocytosis X]]
* [[Hemangioma]]
* [[Lymphangioma]]
* [[Splenic cyst]]
* [[Hamartomas]]
* [[Eosinophilic granuloma]]
</div>
|}
===Causes of Massive Splenomegaly (>1000 gms)===
*[[Autoimmune hemolytic anemia]]
*[[Chronic lymphocytic leukemia]]
*[[Chronic myelogenous leukemia]]
*[[Gauchers disease]]
*[[Hairy cell leukemia]]
*[[Kala-Azar]] ([[Leishmaniasis]])
*[[Lymphomas]]
*[[Malaria]]
*[[Myelofibrosis]]
*[[Polycythemia vera]]
*[[Portal hypertension]] of [[Bilharziasis]]
*[[Sarcoidosis]]
*[[Thalassemia]]


===Causes by Organ System===
===Causes by Organ System===


{|style="width:80%; height:100px" border="1"
{| style="width:80%; height:100px" border="1"
|style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" |'''Cardiovascular'''
| style="width:25%" bgcolor="LightSteelBlue" ; border="1" |'''Cardiovascular'''
|style="height:100px"; style="width:75%" border="1" bgcolor="Beige" | [[Congestive heart failure]], [[Constrictive pericarditis]], [[Infective endocarditis]]  
| style="width:75%" bgcolor="Beige" ; border="1" | [[Congestive heart failure]], [[Constrictive pericarditis]], [[Infective endocarditis]]  
|-
|-
|bgcolor="LightSteelBlue"| '''Chemical/Poisoning'''
| bgcolor="LightSteelBlue" | '''Chemical/Poisoning'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dental'''
| '''Dental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Dermatologic'''
| '''Dermatologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Drug Side Effect'''
| '''Drug Side Effect'''
|bgcolor="Beige"| [[Cidofovir]], [[Filgrastim]]  
| bgcolor="Beige" | [[Cidofovir]], [[Filgrastim]]  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ear Nose Throat'''
| '''Ear Nose Throat'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Endocrine'''
| '''Endocrine'''
|bgcolor="Beige"|  [[Thyrotoxicosis]]  
| bgcolor="Beige" |  [[Thyrotoxicosis]]  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Environmental'''
| '''Environmental'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Gastroenterologic'''
| '''Gastroenterologic'''
|bgcolor="Beige"| [[Cirrhosis]], [[Cruveilhier-Baumgarten syndrome]], [[Hepatic portal vein obstruction]], [[Hepatic vein thrombosis]], [[Portal hypertension]], [[Splenic vein thrombosis]]  
| bgcolor="Beige" | [[Cirrhosis]], [[Cruveilhier-Baumgarten syndrome]], [[Hepatic portal vein obstruction]], [[Hepatic vein thrombosis]], [[Portal hypertension]], [[Splenic vein thrombosis]]  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Genetic'''
| '''Genetic'''
|bgcolor="Beige"| [[Aicardi Goutieres syndrome]], [[Alpha-mannosidase deficiency]], [[Apolipoprotein C-II deficiency]], [[Chanarin-Dorfman disease]], [[Chediak-Higashi disease]], [[Cholesterol ester storage disease]], [[Familial alphalipoprotein deficiency]], [[Familial histiocytic reticulosis]], [[Familial hypertriglyceridaemia]], [[Farber lipogranulomatosis]], [[Fucosidosis]], [[Fumarate hydratase deficiency]], [[Galactose epimerase deficiency]], [[Galactose-1-phosphate uridyltransferase deficiency]], [[Gamma heavy chain disease]], [[Gangliosidosis GM1, type 1]], [[Gangliosidosis GM1, type 3]], [[GM2 gangliosidosis]], [[Gaucher's disease]], [[Glucose phosphate isomerase deficiency]], [[Glycogen storage disease]], [[Haemochromatosis]], [[Hurler syndrome]], [[Hurler-Scheie syndrome]], [[Hyperlipidemia]], [[Iduronate-2-sulfatase deficiency]], [[Kartagener syndrome]], [[Langerhans cell histiocytosis ]], [[Lecithin cholesterol acyltransferase deficiency]], [[Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency]], [[McLeod syndrome]], [[Mevalonate kinase deficiency]], [[Mu chain disease]], [[Mucolipidosis II alpha/beta]], [[Mucopolysaccharidosis VI]], [[Mucopolysaccharidosis VII]], [[Nakajo-Nishimura syndrome]], [[Niemann-Pick disease]], [[Prolidase deficiency]], [[Salla disease]], [[Sandhoff disease]], [[Sanfilippo disease]], [[Sea blue histiocytosis]], [[Sialidosis ]], [[Sphingomyelinase deficiency]], [[Tyrosinaemia type 1]], [[Zimmermann-Laband syndrome]]  
| bgcolor="Beige" | [[Aicardi Goutieres syndrome]], [[Alpha-mannosidase deficiency]], [[Apolipoprotein C-II deficiency]], [[Chanarin-Dorfman disease]], [[Chediak-Higashi disease]], [[Cholesterol ester storage disease]], [[Familial alphalipoprotein deficiency]], [[Familial histiocytic reticulosis]], [[Familial hypertriglyceridaemia]], [[Farber lipogranulomatosis]], [[Fucosidosis]], [[Fumarate hydratase deficiency]], [[Galactose epimerase deficiency]], [[Galactose-1-phosphate uridyltransferase deficiency]], [[Gamma heavy chain disease]], [[Gangliosidosis GM1, type 1]], [[Gangliosidosis GM1, type 3]], [[GM2 gangliosidosis]], [[Gaucher's disease]], [[Glucose phosphate isomerase deficiency]], [[Glycogen storage disease]], [[Haemochromatosis]], [[Hurler syndrome]], [[Hurler-Scheie syndrome]], [[Hyperlipidemia]], [[Iduronate-2-sulfatase deficiency]], [[Kartagener syndrome]], [[Langerhans cell histiocytosis ]] , [[Lecithin cholesterol acyltransferase deficiency]], [[Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency]], [[McLeod syndrome]], [[Mevalonate kinase deficiency]], [[Mu chain disease]], [[Mucolipidosis II alpha/beta]], [[Mucopolysaccharidosis VI]], [[Mucopolysaccharidosis VII]], [[Nakajo-Nishimura syndrome]], [[Niemann-Pick disease]], [[Prolidase deficiency]], [[Salla disease]], [[Sandhoff disease]], [[Sanfilippo disease]], [[Sea blue histiocytosis]], [[Sialidosis ]] , [[Sphingomyelinase deficiency]], [[Tyrosinaemia type 1]], [[Zimmermann-Laband syndrome]]  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Hematologic'''
| '''Hematologic'''
|bgcolor="Beige"|  [[Acute and chronic hemolytic anemias, all etiologies]], [[Autoimmune hemolytic anemia]], [[Congenital dyserythropoietic anaemia type 1]], [[Congenital erythropoeitic porphyria]], [[Coproporphyria, hereditary]], [[Granuloma| Eosinophillic granuloma]], [[Essential thrombocythemia]], [[Extramedullary haemopoiesis]], [[Haemoglobin C disease]], [[Haemoglobin E disease]], [[Haemoglobin SC disease]], [[Haemolytic disease of the newborn]], [[Hemolytic anemia]], [[Hemophagocytic lymphohistiocytosis]], [[Hereditary spherocytosis]], [[Histiocytosis X]], [[Hypereosinophilic syndrome]], [[Iron deficiency anemia]], [[Letterer-Siwe disease]], [[Mastocytosis]], [[Multiple myeloma]], [[Myelofibrosis]], [[Myeloid leukemia]], [[Myeloid metaplasia]], [[Myeloproliferative syndrome]], [[Osteomyelosclerosis]], [[Paroxysmal nocturnal hemoglobinuria]], [[Polycythemia vera]], [[Primary autoimmune haemolytic anaemia]], [[Primary thrombocythemia, acquired]], [[Rosai-Dorfman disease]], [[Sickle cell crisis]], [[Sickle cell disease]], [[Thalassemia major]], [[Waldenström's macroglobulinemia]]  
| bgcolor="Beige" |  [[Acute and chronic hemolytic anemias, all etiologies]], [[Autoimmune hemolytic anemia]], [[Congenital dyserythropoietic anaemia type 1]], [[Congenital erythropoeitic porphyria]], [[Coproporphyria, hereditary]], [[Granuloma| Eosinophillic granuloma]], [[Essential thrombocythemia]], [[Extramedullary haemopoiesis]], [[Haemoglobin C disease]], [[Haemoglobin E disease]], [[Haemoglobin SC disease]], [[Haemolytic disease of the newborn]], [[Hemolytic anemia]], [[Hemophagocytic lymphohistiocytosis]], [[Hereditary spherocytosis]], [[Histiocytosis X]], [[Hypereosinophilic syndrome]], [[Iron deficiency anemia]], [[Letterer-Siwe disease]], [[Mastocytosis]], [[Multiple myeloma]], [[Myelofibrosis]], [[Myeloid leukemia]], [[Myeloid metaplasia]], [[Myeloproliferative syndrome]], [[Osteomyelosclerosis]], [[Paroxysmal nocturnal hemoglobinuria]], [[Polycythemia vera]], [[Primary autoimmune haemolytic anaemia]], [[Primary thrombocythemia, acquired]], [[Rosai-Dorfman disease]], [[Sickle cell crisis]], [[Sickle cell disease]], [[Thalassemia major]], [[Waldenström's macroglobulinemia]]  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Iatrogenic'''
| '''Iatrogenic'''
|bgcolor="Beige"|  No underlying causes
| bgcolor="Beige" |  No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Infectious Disease'''
| '''Infectious Disease'''
|bgcolor="Beige"|  [[Acanthocheilonemiasis]], [[AIDS]], [[Babesiosis]], [[Bartonellosis]], [[Borreliosis]], [[Cat-Scratch disease]], [[Coronavirus]], [[Corynebacterium diphtheriae]], [[Cytomegalovirus]], [[Dengue]], [[E.coli]], [[Ehrlichiosis]], [[Group B streptococcal infection]], [[Hepatic Echinococcosis]], [[Hepatitis]], [[Histoplasmosis]], [[Infectious mononucleosis]], [[Kala-Azar]], [[Leishmaniasis]], [[Leptospirosis]], [[Lyme disease]], [[Malaria]], [[Mycobacterium avium complex]], [[Paragonimiasis]], [[Psittacosis]], [[Q fever]], [[Relapsing fever]], [[Rickettsiae]], [[RMSF]], [[Rubella]], [[Salmonella]], [[Schistosomiasis]], [[Septicemia]], [[Sleeping sickness]], [[Splenic abscess]], [[Syphilis]], [[Toxocariasis]], [[Toxoplasma]], [[Trench fever]], [[Tropical splenomegaly syndrome]], [[Trypanosomiasis]], [[Tuberculosis]], [[Tularemia]], [[Visceral larva migrans]], [[Weil syndrome]], [[Whipple disease]]  
| bgcolor="Beige" |  [[Acanthocheilonemiasis]], [[AIDS]], [[Babesiosis]], [[Bartonellosis]], [[Borreliosis]], [[Cat-Scratch disease]], [[Coronavirus]], [[Corynebacterium diphtheriae]], [[Cytomegalovirus]], [[Dengue]], [[E.coli]], [[Ehrlichiosis]], [[Group B streptococcal infection]], [[Hepatic Echinococcosis]], [[Hepatitis]], [[Histoplasmosis]], [[Infectious mononucleosis]], [[Kala-Azar]], [[Leishmaniasis]], [[Leptospirosis]], [[Lyme disease]], [[Malaria]], [[Mycobacterium avium complex]], [[Paragonimiasis]], [[Psittacosis]], [[Q fever]], [[Relapsing fever]], [[Rickettsiae]], [[RMSF]], [[Rubella]], [[Salmonella]], [[Schistosomiasis]], [[Septicemia]], [[Sleeping sickness]], [[Splenic abscess]], [[Syphilis]], [[Toxocariasis]], [[Toxoplasma]], [[Trench fever]], [[Tropical splenomegaly syndrome]], [[Trypanosomiasis]], [[Tuberculosis]], [[Tularemia]], [[Visceral larva migrans]], [[Weil syndrome]], [[Whipple disease]]  


|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Musculoskeletal/Orthopedic'''
| '''Musculoskeletal/Orthopedic'''
|bgcolor="Beige"|  [[Osteopetrosis ]]
| bgcolor="Beige" |  [[Osteopetrosis ]]
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Neurologic'''
| '''Neurologic'''
|bgcolor="Beige"|  No underlying causes
| bgcolor="Beige" |  No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Nutritional/Metabolic'''
| '''Nutritional/Metabolic'''
|bgcolor="Beige"| [[Nutritional anemias]], [[Vitamin B12 deficiency]]  
| bgcolor="Beige" | [[Nutritional anemias]], [[Vitamin B12 deficiency]]  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Obstetric/Gynecologic'''
| '''Obstetric/Gynecologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Oncologic'''
| '''Oncologic'''
|bgcolor="Beige"| [[Acute and chronic leukemias]], [[Adult T-cell leukemia]], [[Angioimmunoblastic lymphadenopathy with dysproteinaemia]], [[Angiosarcoma]], [[Autoimmune lymphoproliferative syndrome]], [[Bone marrow infiltration]], [[Castleman's disease]], [[Chronic eosinophilic leukaemia]], [[Chronic lymphocytic leukaemia]], [[Chronic myeloid leukaemia]], [[Fibroma]], [[Geleophysic dysplasia]], [[Hairy cell leukaemia]], [[Hamartomas]], [[Hepatosplenic T-cell lymphoma]],[[Hodgkin lymphoma]], [[Lymphangiomas]], [[Lymphoid leukemia]], [[Lympho-reticulosarcoma]], [[Mantle cell lymphoma]], [[Melanoma]], [[Metastatic solid tumors]], [[Monocytic leukemia]], [[Non-Hodgkin's lymphoma]], [[Primary splenic tumors]], [[Splenic hamartoma]], [[Splenic hemangioma]]  
| bgcolor="Beige" | [[Acute and chronic leukemias]], [[Adult T-cell leukemia]], [[Angioimmunoblastic lymphadenopathy with dysproteinaemia]], [[Angiosarcoma]], [[Autoimmune lymphoproliferative syndrome]], [[Bone marrow infiltration]], [[Castleman's disease]], [[Chronic eosinophilic leukaemia]], [[Chronic lymphocytic leukaemia]], [[Chronic myeloid leukaemia]], [[Fibroma]], [[Geleophysic dysplasia]], [[Hairy cell leukaemia]], [[Hamartomas]], [[Hepatosplenic T-cell lymphoma]],[[Hodgkin lymphoma]], [[Lymphangiomas]], [[Lymphoid leukemia]], [[Lympho-reticulosarcoma]], [[Mantle cell lymphoma]], [[Melanoma]], [[Metastatic solid tumors]], [[Monocytic leukemia]], [[Non-Hodgkin's lymphoma]], [[Primary splenic tumors]], [[Splenic hamartoma]], [[Splenic hemangioma]]  


|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Ophthalmologic'''
| '''Ophthalmologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Overdose/Toxicity'''
| '''Overdose/Toxicity'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Psychiatric'''
| '''Psychiatric'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Pulmonary'''
| '''Pulmonary'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Renal/Electrolyte'''
| '''Renal/Electrolyte'''
|bgcolor="Beige"| [[Nephrotic syndrome]],  
| bgcolor="Beige" | [[Nephrotic syndrome]],  
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Rheumatology/Immunology/Allergy'''
| '''Rheumatology/Immunology/Allergy'''
|bgcolor="Beige"| [[Amyloidosis]], [[Collagen vascular diseases]], [[Common variable hypogammaglobulinaemia]], [[Felty's syndrome]], [[Immune hemolytic anemias]], [[Juvenile chronic arthritis]], [[Macrophage activation syndrome]], [[Mixed essential cryoglobulinaemia]], [[Primary biliary cirrhosis]], [[Sarcoidosis]], [[Serum sickness]], [[Still disease, adult-onset]], [[Still disease, juvenile-onset]], [[Systemic lupus erythematosus]]  
| bgcolor="Beige" | [[Amyloidosis]], [[Collagen vascular diseases]], [[Common variable hypogammaglobulinaemia]], [[Felty's syndrome]], [[Immune hemolytic anemias]], [[Juvenile chronic arthritis]], [[Macrophage activation syndrome]], [[Mixed essential cryoglobulinaemia]], [[Primary biliary cirrhosis]], [[Sarcoidosis]], [[Serum sickness]], [[Still disease, adult-onset]], [[Still disease, juvenile-onset]], [[Systemic lupus erythematosus]]  
   
   
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Sexual'''
| '''Sexual'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Trauma'''
| '''Trauma'''
|bgcolor="Beige"| [[Trauma]]  
| bgcolor="Beige" | [[Trauma]]  


|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Urologic'''
| '''Urologic'''
|bgcolor="Beige"| No underlying causes
| bgcolor="Beige" | No underlying causes
|-
|-
|-bgcolor="LightSteelBlue"
|- bgcolor="LightSteelBlue"
| '''Miscellaneous'''
| '''Miscellaneous'''
|bgcolor="Beige"| [[Idiopathic splenomegaly]], [[Splenic artery aneurysm]], [[Splenic cyst]]   
| bgcolor="Beige" | [[Idiopathic splenomegaly]], [[Splenic artery aneurysm]], [[Splenic cyst]]   
|-
|-
|}
|}
Line 196: Line 275:
===Causes in Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===
===Causes in Alphabetical Order<ref>Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016</ref> <ref>Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X</ref>===


{{columns-list|3|
{{columns-list|
   
   
*[[Acanthocheilonemiasis]]
*[[Acanthocheilonemiasis]]
Line 395: Line 474:
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
 
{{WH}}
{{WS}}


[[Category:Hematology]]
[[Category:Hematology]]
[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Primary care]]
{{WH}}
{{WS}}

Latest revision as of 00:14, 30 July 2020


Template:Splenomegaly Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Venkata Sivakrishna Kumar Pulivarthi M.B.B.S [2]

Overview

The causes of splenomegaly vary widely and range from increased splenic function (such as hemoglobinopathies), splenic congestion due to abnormal blood flow (such as venous obstruction), and splenic infiltration (such as storage disorders and malignancies).

Causes

Common Causes

Less Common Causes [1]

Rickets

Causes by Pathogenesis

Mechanism Pathogenesis Example
Increased function Removal of defective RBCs
Immune hyperplasia Response to infection (viral, bacterial, fungal, parasitic)
Disordered immunoregulation
Drug reactions
Extramedullary hematopoiesis
Abnormal blood flow Organ Failure
Vascular
Infections
Infiltration Metabolic diseases
Benign and malignant infiltrations

Causes of Massive Splenomegaly (>1000 gms)

Causes by Organ System

Cardiovascular Congestive heart failure, Constrictive pericarditis, Infective endocarditis
Chemical/Poisoning No underlying causes
Dental No underlying causes
Dermatologic No underlying causes
Drug Side Effect Cidofovir, Filgrastim
Ear Nose Throat No underlying causes
Endocrine Thyrotoxicosis
Environmental No underlying causes
Gastroenterologic Cirrhosis, Cruveilhier-Baumgarten syndrome, Hepatic portal vein obstruction, Hepatic vein thrombosis, Portal hypertension, Splenic vein thrombosis
Genetic Aicardi Goutieres syndrome, Alpha-mannosidase deficiency, Apolipoprotein C-II deficiency, Chanarin-Dorfman disease, Chediak-Higashi disease, Cholesterol ester storage disease, Familial alphalipoprotein deficiency, Familial histiocytic reticulosis, Familial hypertriglyceridaemia, Farber lipogranulomatosis, Fucosidosis, Fumarate hydratase deficiency, Galactose epimerase deficiency, Galactose-1-phosphate uridyltransferase deficiency, Gamma heavy chain disease, Gangliosidosis GM1, type 1, Gangliosidosis GM1, type 3, GM2 gangliosidosis, Gaucher's disease, Glucose phosphate isomerase deficiency, Glycogen storage disease, Haemochromatosis, Hurler syndrome, Hurler-Scheie syndrome, Hyperlipidemia, Iduronate-2-sulfatase deficiency, Kartagener syndrome, Langerhans cell histiocytosis  , Lecithin cholesterol acyltransferase deficiency, Long-chain 3-hydroxyacyl-coenzyme A dehydrogenase deficiency, McLeod syndrome, Mevalonate kinase deficiency, Mu chain disease, Mucolipidosis II alpha/beta, Mucopolysaccharidosis VI, Mucopolysaccharidosis VII, Nakajo-Nishimura syndrome, Niemann-Pick disease, Prolidase deficiency, Salla disease, Sandhoff disease, Sanfilippo disease, Sea blue histiocytosis, Sialidosis , Sphingomyelinase deficiency, Tyrosinaemia type 1, Zimmermann-Laband syndrome
Hematologic Acute and chronic hemolytic anemias, all etiologies, Autoimmune hemolytic anemia, Congenital dyserythropoietic anaemia type 1, Congenital erythropoeitic porphyria, Coproporphyria, hereditary, Eosinophillic granuloma, Essential thrombocythemia, Extramedullary haemopoiesis, Haemoglobin C disease, Haemoglobin E disease, Haemoglobin SC disease, Haemolytic disease of the newborn, Hemolytic anemia, Hemophagocytic lymphohistiocytosis, Hereditary spherocytosis, Histiocytosis X, Hypereosinophilic syndrome, Iron deficiency anemia, Letterer-Siwe disease, Mastocytosis, Multiple myeloma, Myelofibrosis, Myeloid leukemia, Myeloid metaplasia, Myeloproliferative syndrome, Osteomyelosclerosis, Paroxysmal nocturnal hemoglobinuria, Polycythemia vera, Primary autoimmune haemolytic anaemia, Primary thrombocythemia, acquired, Rosai-Dorfman disease, Sickle cell crisis, Sickle cell disease, Thalassemia major, Waldenström's macroglobulinemia
Iatrogenic No underlying causes
Infectious Disease Acanthocheilonemiasis, AIDS, Babesiosis, Bartonellosis, Borreliosis, Cat-Scratch disease, Coronavirus, Corynebacterium diphtheriae, Cytomegalovirus, Dengue, E.coli, Ehrlichiosis, Group B streptococcal infection, Hepatic Echinococcosis, Hepatitis, Histoplasmosis, Infectious mononucleosis, Kala-Azar, Leishmaniasis, Leptospirosis, Lyme disease, Malaria, Mycobacterium avium complex, Paragonimiasis, Psittacosis, Q fever, Relapsing fever, Rickettsiae, RMSF, Rubella, Salmonella, Schistosomiasis, Septicemia, Sleeping sickness, Splenic abscess, Syphilis, Toxocariasis, Toxoplasma, Trench fever, Tropical splenomegaly syndrome, Trypanosomiasis, Tuberculosis, Tularemia, Visceral larva migrans, Weil syndrome, Whipple disease
Musculoskeletal/Orthopedic Osteopetrosis
Neurologic No underlying causes
Nutritional/Metabolic Nutritional anemias, Vitamin B12 deficiency
Obstetric/Gynecologic No underlying causes
Oncologic Acute and chronic leukemias, Adult T-cell leukemia, Angioimmunoblastic lymphadenopathy with dysproteinaemia, Angiosarcoma, Autoimmune lymphoproliferative syndrome, Bone marrow infiltration, Castleman's disease, Chronic eosinophilic leukaemia, Chronic lymphocytic leukaemia, Chronic myeloid leukaemia, Fibroma, Geleophysic dysplasia, Hairy cell leukaemia, Hamartomas, Hepatosplenic T-cell lymphoma,Hodgkin lymphoma, Lymphangiomas, Lymphoid leukemia, Lympho-reticulosarcoma, Mantle cell lymphoma, Melanoma, Metastatic solid tumors, Monocytic leukemia, Non-Hodgkin's lymphoma, Primary splenic tumors, Splenic hamartoma, Splenic hemangioma
Ophthalmologic No underlying causes
Overdose/Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte Nephrotic syndrome,
Rheumatology/Immunology/Allergy Amyloidosis, Collagen vascular diseases, Common variable hypogammaglobulinaemia, Felty's syndrome, Immune hemolytic anemias, Juvenile chronic arthritis, Macrophage activation syndrome, Mixed essential cryoglobulinaemia, Primary biliary cirrhosis, Sarcoidosis, Serum sickness, Still disease, adult-onset, Still disease, juvenile-onset, Systemic lupus erythematosus
Sexual No underlying causes
Trauma Trauma
Urologic No underlying causes
Miscellaneous Idiopathic splenomegaly, Splenic artery aneurysm, Splenic cyst

Causes in Alphabetical Order[2] [3]

References

  1. ↑ Kahan, Scott, Smith, Ellen G. In a page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:157
  2. ↑ Sailer, Christian, Wasner, Susanne. Differential Diagnosis Pocket. Hermosa Beach, CA: Borm Bruckmeir Publishing LLC, 2002:77 ISBN 1591032016
  3. ↑ Kahan, Scott, Smith, Ellen G. In A Page: Signs and Symptoms. Malden, Massachusetts: Blackwell Publishing, 2004:68 ISBN 140510368X

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