Approach to a child with hepatosplenomegaly soumya ranjan parida basic b. Fever, hepatosplenomegaly, and pancytopenia in a 5monthold. Pushpa raj sharma professor of child health institute of medicine case history eight months, male, from rupandehi. Hepatosplenomegaly in pediatrics by sami aswad on prezi. Subsequent contrastenhanced ct of the abdomen verifies the presence of increased bone density secondary to organized trabecular thickening and deposition along the endosteal cortex. There are different medical conditions that can lead to the simultaneous appearance of hepatomegaly and splenomegaly, as you will have the opportunity to discover below. Supported in part from nih grants am16269 and gm21700 and a u. Kupffer cell hyperplasia with tb or other generalized. Prolonged fever, hepatosplenomegaly, and pancytopenia in a 46yearold woman article pdf available in plos medicine 64. Pdf prolonged fever, hepatosplenomegaly, and pancytopenia.
Seema alam pediatric hepatologist, ilbs, new delhi panelists. When both, your liver and your spleen become enlarged, it is a condition. The approach outlined here is based on the abovementioned classification, clinical scenario and full blood count fbc findings. Splenomegaly is a symptom that can be caused by a variety of conditions that affect different organ systems. Hepatosplenomegaly hpm is a disorder where both the liver and spleen swell beyond their normal size, due to one of a number of causes. Delay of developmental motor milestones from the age of 89 months and central hypotonia constitute the first neurological symptoms, which become more evident between 1 and 2 years of age. Hepatosplenomegaly in a young child can be an ominous physical finding, potentially representing a metabolic, malignant, or infectious process. Pancytopenia haemoglobin of dec 20, 20 hepatosplenomegaly how do we approach 1. Davis, md, anmed health family medicine residency program. Depending on the cause, it may sometimes present along with jaundice. Multiple myeloma presenting with hepatosplenomegaly article pdf available in the journal of the association of physicians of india 597. Hepatosplenomegaly medical definition merriamwebster. Classification of splenomegaly hackett 0 spleen not. We present the case of a 5monthold girl who had fever, hepatosplenomegaly, and hematologic abnormalities at the initial examination.
What are the complications associated with hepatosplenomegaly. Oct 15, 2018 liver and spleen enlargement hepatosplenomegaly can occur as the result of an inherited disorder in which the liver cannot process glucocerebroside. Pushpa raj sharma professor of child health institute of medicine slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising. Hepatosplenomegaly hsm isnt always serious, but it can represent an indicator of a very serious medical condition. Necessary to specify the age at which there were first signs of the disease hepatosplenomegaly in children is more common than in adults, since early communication elements of a single mononuclear phagocytic system is much stronger, the presence of similar. Hepatomegaly is the condition of having an enlarged liver. Th ere are oft en some subtle clues to the aetiology which may be present, so take care to examine for anaemia, splinter haemorrhages and.
Among the many causes for these findings is severe rickets, which has been shown to be associated with secondary myelofibrosis and myeloid metaplasia. This caucasian newborn boy was transferred for evaluation of hepatosplenomegaly. Diffuse osteosclerosis with hepatosplenomegaly case history a 59yearold man presents with left flank pain. In gaucher disease, liver and spleen enlargement hepatosplenomegaly can occur as the result of the liver not processing glucocerebroside properly. Ppt approach to a child with hepatosplenomegaly powerpoint. A free powerpoint ppt presentation displayed as a flash slide show on id. Full text full text is available as a scanned copy of the original print version. Pdf multiple myeloma presenting with hepatosplenomegaly. Hepatosplenomegaly symptoms, diagnosis, treatments and. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly.
Differential diagnosis of hepatosplenomegaly homeopathy. Kupffer cell hyperplasia with tb or other generalized infections 3. Leukaemias lymphomas myelofibrosis myeloproliferative disease essential thrombocytopenia, polycythaemia, primary myelofibrosis, cml haemolytic anaemias hb disorders. Hepatosplenomegaly information including symptoms, diagnosis, misdiagnosis, treatment, causes, patient stories, videos, forums, prevention, and prognosis. Radiologic description frontal radiography of the abdomen fig. Diagnostic algorithm is based on a thorough observation of data from medical history and patient complaints and physical examination. Pronunciation of hepatosplenomegaly with 3 audio pronunciations, 1 meaning, 11 translations and more for hepatosplenomegaly. Hepatosplenomegaly commonly abbreviated hsm is the simultaneous enlargement of both the liver hepatomegaly and the spleen splenomegaly. There are many complications that can lead to hsm in fact, the list is remarkably long. He was the 6pound, 7 ounce product of an uncomplicated 37 week gestation to a 38yearold g2p2 female. Invision employees share their remote work secrets. Prolonged fever, hepatosplenomegaly, and pancytopenia in a 46.
Get a printable copy pdf file of the complete article 297k, or click on a page image below to browse page by page. It is a nonspecific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic. Hepatosplenomegaly symptoms, diagnosis, treatments and causes. Approach to a child with hepatosplenomegaly summary of pathophysiological mechanisms 1. Therefore, screening tests can play an important role in the workup of a patient with hepatosplenomegaly and a suspected lysosomal or lipid storage disorder. The patients laboratory results revealed pancytopenia with 2,800 leukocytesmm 3 2,200 neutrophils, 400 lymphocytes, 200.
The workup is best guided by a meticulous history, with particular attention paid to the presence and duration of associated symptoms and possible environmental or. Prolonged fever, hepatosplenomegaly, and pancytopenia in a. Hepatosplenomegaly what is,causes,symptoms,treatment, etc. Differential diagnosis of causes of hepatosplenomegaly in alphabetical order. He was the 6pound, 7 ounce product of an uncomplicated 37 week gestation. Army research and development contract dada1770c01. Often, hepatomegaly will present as an abdominal mass. Approach to hepatomegaly, splenomegaly and hepatosplenomegaly free download as powerpoint presentation. Thrombocytopenia is defined as a platelet count of less than 150. Hepatosplenomegaly aetiology of hepatosplenomegaly chronic liver disease and portal hypertension see chronic liver disease section for further differentials haematological disease. Hepatomegaly is enlargement of the liver beyond its normal size and occurs mainly as a consequence of pathologic conditions.
Approach to practical pediatrics download ebook pdf. The studies ive seen have been on boys with micropenis penis jan 18, 2011 approach to a child with hepatosplenomegaly. Hepatosplenomegaly can occur as the result of acute viral hepatitis, infectious mononucleosis, and histoplasmosis or it can be the sign of a serious and lifethreatening lysosomal storage disease. Fever with cough and difficulty breathing for one week, more severe for one day. Pushpa raj sharma professor of child health institute of medicine. Among the many causes for these findings is severe rickets, which has been shown to be. Anemia and hepatosplenomegaly are common reasons for referring a child to a pediatric hematologist or oncologist. Subsequent contrastenhanced ct of the abdomen verifies the presence of. If you experience any of the symptoms of hepatosplenomegaly, consult a doctor immediately. Viral infection viral infection like hepatitis, rubella. Diagnostic approach to a patient with suspected anaemia as anaemia may manifest in a wide range of disorders, a streamlined diagnostic approach is vital fig.
Lynn wachtman, keith mansfield, in nonhuman primates in biomedical research second edition, 2012. Hepatosplenomegaly is a complicated disorder often an indication of some serious medical conditions. Uptodate, electronic clinical resource tool for physicians and patients that provides information on adult primary care and internal medicine, allergy and immunology, cardiovascular medicine, emergency. Hepatosplenomegaly an overview sciencedirect topics. Hepatosplenomegaly is the simultaneous enlargement of both the liver hepatomegaly and the spleen splenomegaly. Massachusetts general hospital, boston, massachusetts 02114 hepatomegaly an approach to differential diagnosis w. Apr 14, 2009 the diagnostic approach should be based on any potential clues in the patients history, physical examination, and routine screening blood tests and cultures. Hepatosplenomegaly often with a history of neonatal icterus has been present since early life.
Multiple blood, urine, and stool cultures were negative. Walker is a recipient of an academic career development award ko4am00021, from the niamdd. Hepatosplenomegaly is a medical condition in which both the liver and the spleen become enlarged. There are different medical conditions that can lead to the simultaneous appearance of hepatomegaly. Approach to a child with hepatosplenomegaly better always. Hepatosplenomegaly can occur as the result of acute. It is a nonspecific medical sign having many causes, which can broadly be broken down into infection, hepatic tumours, or metabolic disorder. It is often discovered incidentally when it is often discovered incidentally when obtaining a complete blood count. Necessary to specify the age at which there were first. When evaluating a child with splenomegaly it is important to identify conditions in which immediate medical intervention is needed and provide appropriate treatment options.
Sep 19, 2017 hepatosplenomegaly hpm is a disorder where both the liver and spleen swell beyond their normal size, due to one of a number of causes. Splenomegaly general presentation the spleen is a hematopoietic organ supporting the megakaryotic, lymphoid, erythroid, myeloid, and reticuloendothelial systems. The name of this condition hepatosplenomegaly comes. Frontal radiography of the abdomen shows diffuse osteosclerosis and concurrent severe splenomegaly and hepatomegaly. Fever, hepatosplenomegaly, and pancytopenia in a 5month. Calcarea fluorica pathologial approach in remedy selection. Click download or read online button to get approach to practical. Hepatosplenomegaly how do we approach linkedin slideshare. Anemia and hepatosplenomegaly as presenting features in. Jul 12, 2011 the hepatosplenomegaly is generally found out by the physician. May 6, 2020 infections of central nervous system, bacterial meningitis. The internist approach to lymphocytosis clin assoc prof p kuperan frcp, frcpa, frcpath. Feb 01, 20 approach to a childwithhepatosplenomegaly dr.
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