Wallach's Interpretation of Diagnostic Tests: Pathways to Arriving at a Clinical Diagnosis (360 page)

Enlargement of the spleen that can be demonstrated either by physical examination or by imaging studies. Splenomegaly reflects an underlying disease. Finding splenomegaly should trigger systemic investigation of its etiology.

   Who Should Be Suspected?

Patients with abdominal fullness, early satiety, or chronic or acute left upper abdominal pain.

   Common causes of splenomegaly are as follows:

   Infections

   Infectious endocarditis

   Infectious mononucleosis

   Brucellosis

   Miliary tuberculosis

   Parasitic infections: malaria, schistosomiasis, kala-azar

   Fungal diseases

   Vascular (systemic or portal) congestion (congestive splenomegaly)

   Immune disorders

   RA (Felty syndrome)

   SLE