Hematology A diagnostic tool in cases of splenomegaly

Abstract

Objective: To study hematological profile in patients with clinically palpable spleen and to find out the role of hematological investigations as a diagnostic tool in elucidating etiopathogenesis of splenomegaly. Materials and methods: This cross-sectional study was conducted on 50 patients at a teaching hospital from Aug 2011 to 2013. Detailed clinical history including name, age, sex, chief complaints, clinical findings, X-ray and USG (if done) were noted. Grading of splenomegaly was done by Hackett's classification. Laboratory tests including peripheral blood smear, complete blood count and bone marrow examination (if required) were performed. Results: In the present study, maximum numbers of patients were males in the age group of 0-15 years. The commonest cause of splenomegaly found was acute leukemia followed by malaria, hemolytic anemia, chronic myeloid leukemia, liver cirrhosis and infections. Hematological causes were the most common etiology of splenomegaly in this study. The commonest grade of splenomegaly was I and II (mild). There was also a case of congenital dyserythropoietic anemia type I (CDA), a rare autosomal recessive disorder. We also came across one case of plasmodium falciparum malaria with no evidence of parasite on peripheral blood smear which called for bone marrow study. Conclusion: Splenomegaly is a subject of considerable clinical concern as spleen is not palpable under normal circumstances. When palpable, it may be associated with serious disorders from which no age is exempted. Thus, hematological evaluation becomes necessary to understand the etiopathogenesis of splenomegaly.