25. Splenomegaly. causes, diagnosis and differential diagnosis.

Page created on February 15, 2022. Last updated on March 1, 2022 at 12:15


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

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