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• On physical examination, splenomegaly is generally defined as a palpable splenic edge felt >2 cm below the left costal margin. A palpable spleen tip may be a normal finding in up to 30 percent of neonates; the frequency drops to approximately 10 percent in healthy school-age children and <3 percent in young adults.
This topic provides an overview of normal splenic size and function and an approach to evaluating splenic abnormalities in adults. The evaluation of splenomegaly in children and considerations related to elective or traumatic splenectomy are discussed separately.
Pancytopenia – Causes of pancytopenia in children include infection, myelosuppressive medications, leukemia, aplastic anemia, and hypersplenism. (See "Aplastic anemia: Pathogenesis, clinical manifestations, and diagnosis" and "Overview of the clinical presentation and diagnosis of acute lymphoblastic leukemia/lymphoma in children" and ...
The major hematologic manifestations of SLE may include isolated or concurrent cytopenias (including anemia, leukopenia, and thrombocytopenia), lymphadenopathy, and/or splenomegaly. Cytopenias in patients with SLE may also be related to comorbid diseases (eg, anemia from chronic kidney disease) and/or treatments for SLE.
- Causes of eosinophilia - Epidemiologic clues to the diagnosis of lymphadenopathy - Causes of splenomegaly
Evaluation of a patient with eosinophilia should seek to identify the underlying cause and assess the patient for associated organ involvement. This topic presents our approach to evaluation of unexplained peripheral blood eosinophilia.
This topic provides an overview of normal liver size, causes of hepatomegaly, and an approach to evaluating hepatomegaly in adults. The diagnosis and management of hepatic injury in adults is discussed separately.
People with mono, who develop an enlarged spleen are at risk of splenic rupture until the spleen returns to normal size. This can take a few weeks or longer. Although you can return to school or work when you are feeling better, it's important to avoid activities that can cause injury to the spleen.
Physical findings are nonspecific, but may include pallor, petechiae, purpura, mucosal ulceration/gingivitis, or stigmata of infections. Hepatomegaly, splenomegaly, and lymphadenopathy are uncommon and, if present, suggest an alternative diagnosis, such as a lymphoma.
Although relatively rare, hereditary spherocytosis (HS) is the most common cause of hemolytic anemia due to a red cell membrane defect. It is a result of heterogeneous alterations in one of five genes that encode red blood cell (RBC) membrane proteins involved in vertical associations that link the membrane cytoskeleton to the lipid bilayer.