Page created on February 15, 2022. Last updated on March 1, 2022 at 12:15
Evaluation
In some children, especially neonates, the spleen may be palpatable despite the spleen being normal. When the spleen extends more than 2 cm below the left costal margin, it’s considered abnormal.
Differential diagnosis of splenomegaly
| Etiology | Typical features |
| Mononucleosis | Bilateral cervical lymphadenopathy, exudate on tonsils |
| Leukaemia/lymphoma | Generalised, malaise, infections, skin bleeding, lymphadenopathy, B symptoms |
| Sickle cell disease/thalassaemia | African/Mediterranean ethnicity, jaundice, anaemia |
| Liver disease (via portal hypertension) | Features of liver disease |
| Congenital TORCH | Congenital malformations |
| SLE, systemic JIA | Arthritis, fever, serositis, rash |
| Infective endocarditis | Fever, ill child, embolic phenomena, new murmur, pallor |