CLINICAL DIAGNOSTIC MANUAL
Massive splenomegaly refers to a significant enlargement of the spleen, palpable more than five fingers below the left costal margin. This degree of splenomegaly indicates a severe and generally chronic pathological condition that substantially affects spleen function.
Massive splenomegaly may be indicative of haematological, infectious, and systemic disorders requiring immediate evaluation and treatment. Recognising the underlying cause is essential for appropriate patient management.
Condition | Symptoms and Clinical Signs | Suspicion Diagnosis | Confirmatory Diagnosis |
Chronic Myeloid Leukaemia | Fatigue, weight loss, night sweats, fever, pain or fullness in the left upper quadrant, easy bruising, anaemia | Clinical history, clinical symptoms | Complete blood count, peripheral blood smear, bone marrow biopsy |
Myelofibrosis | Fatigue, weight loss, night sweats, fullness or pain in the left upper quadrant, anaemia, recurrent infections, bleeding | Clinical history, clinical symptoms | Complete blood count, bone marrow biopsy |
Malaria | Intermittent fever, chills, sweating, headache, abdominal pain, massive splenomegaly, anaemia, jaundice | Travel history to endemic areas, clinical symptoms | Peripheral blood smear, rapid diagnostic tests for malaria |
Kala-azar (Visceral Leishmaniasis) | Prolonged fever, weight loss, fatigue, massive splenomegaly, hepatomegaly, anaemia, pancytopenia, skin hyperpigmentation | Clinical history, clinical symptoms | Serology for leishmaniasis, bone marrow aspiration |
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