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Table 10.1 Causes of Splenomegaly.: Haematological

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Naveen Koval

This document contains four tables that list causes and indications for splenomegaly and hyposplenism, as well as vaccination recommendations for patients with hyposplenism. Table 10.1 lists various haematological, systemic, infectious, and storage diseases that can cause splenomegaly. Table 10.2 outlines causes of hyposplenism and the resulting blood film features. Table 10.3 indicates situations where splenectomy is recommended, such as for splenic rupture or various haematological conditions. Table 10.4 provides vaccination guidelines for patients with hyposplenism, including pneumococcal, meningococcal, and influenza vaccines.

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Table 10.1 Causes of Splenomegaly.: Haematological

Uploaded by

Naveen Koval
48 views2 pages
This document contains four tables that list causes and indications for splenomegaly and hyposplenism, as well as vaccination recommendations for patients with hyposplenism. Table 10.1 lists various haematological, systemic, infectious, and storage diseases that can cause splenomegaly. Table 10.2 outlines causes of hyposplenism and the resulting blood film features. Table 10.3 indicates situations where splenectomy is recommended, such as for splenic rupture or various haematological conditions. Table 10.4 provides vaccination guidelines for patients with hyposplenism, including pneumococcal, meningococcal, and influenza vaccines.

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This document contains four tables that list causes and indications for splenomegaly and hyposplenism, as well as vaccination recommendations for patients with hyposplenism. Table 10.1 lists various haematological, systemic, infectious, and storage diseases that can cause splenomegaly. Table 10.2 outlines causes of hyposplenism and the resulting blood film features. Table 10.3 indicates situations where splenectomy is recommended, such as for splenic rupture or various haematological conditions. Table 10.4 provides vaccination guidelines for patients with hyposplenism, including pneumococcal, meningococcal, and influenza vaccines.

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48 views2 pages

Table 10.1 Causes of Splenomegaly.: Haematological

Uploaded by

Naveen Koval
This document contains four tables that list causes and indications for splenomegaly and hyposplenism, as well as vaccination recommendations for patients with hyposplenism. Table 10.1 lists various haematological, systemic, infectious, and storage diseases that can cause splenomegaly. Table 10.2 outlines causes of hyposplenism and the resulting blood film features. Table 10.3 indicates situations where splenectomy is recommended, such as for splenic rupture or various haematological conditions. Table 10.4 provides vaccination guidelines for patients with hyposplenism, including pneumococcal, meningococcal, and influenza vaccines.

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Table 10.1 Causes of splenomegaly.

Haematological
Chronic myeloid leukaemia*
Chronic lymphocytic leukaemia
Acute leukaemia
Lymphoma*
Primary myelofibrosis*
Polycythaemia vera
Hairy cell leukaemia
Thalassaemia major or intermedia*
Sickle cell anaemia (before splenic infarction)
Haemolytic anaemias
Megaloblastic anaemia
Portal hypertension
Cirrhosis
Hepatic, portal, splenic vein thrombosis
Storage diseases
Gauchers disease*
NiemannPick disease
Histiocytosis X
Systemic diseases
Sarcoidosis
Amyloidosis
Collagen diseases systemic lupus
erythematosus, rheumatoid arthritis
Systemic mastocytosis
Infections
Acute: septicaemia, bacterial endocarditis,
typhoid, infectious mononucleosis
Chronic: tuberculosis, brucellosis, syphilis,
malaria, leishmaniasis,* schistosomiasis*
Tropical*
Possibly caused by malaria
*Possible causes of massive (>20cm) splenomegaly.

Table 10.2 Causes of hyposplenism and


blood film features.
Causes

Blood film features

Splenectomy
Sickle cell disease
Essential
thrombocythaemia
Adult gluten-induced
enteropathy
Dermatitis
herpetiformis
Rarely
inflammatory bowel
disease
splenic arterial
thrombosis

Red cells
Target cells
Acanthocytes
Irregularly contracted
or crenated cells
HowellJolly bodies
(DNA remnants)
Siderotic (iron)
granules
(Pappenheimer
bodies)
White cells
Mild lymphocytosis,
monocytosis
Platelets
Thrombocytosis

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2/8/2011 11:48:21 AM

Table 10.3 Indications for splenectomy.


Splenic rupture
Chronic immune thrombocytopenia
Haemolytic anaemia (some cases), e.g.
hereditary spherocytosis, autoimmune
haemolytic anaemia, thalassaemia major or
intermedia
Chronic lymphocytic leukaemia and lymphomas
Primary myelofibrosis
Tropical splenomegaly

Table 10.4 Recommendations for vaccination of patients with hyposplenism.


Revaccination
schedule

Vaccine

Time of vaccination

1 Pneumoccal polyvalent
vaccine

If possible, at least 2
weeks prior to
splenectomy

5 yearly

Assessment of antibody
response may be useful

2 Combined Haemophilus
influenzae type b conjugate
and meningococcal C
conjugate

Alternatively, 2 weeks
post-splenectomy for all
three vaccines

Not required
Not required

Not required if
previously vaccinated

3 Influenza

As soon as available for


seasonal protection

Annual

Inactivated subunit
vaccine

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Comments

2/8/2011 11:48:21 AM

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