FREQUENCY AND ETIOLOGY OF SPLENOMEGALY IN ADULTS SEEKING MEDICAL ADVICE IN COMBINED MILITARY HOSPITAL ATTOCK

Authors

  • Asif Nadeem
  • Nadir Ali
  • Tasawar Hussain
  • Masood Anwar

Abstract

Background: The concept that a palpable spleen can be associated with disease is natural, because this organ normally is not palpable, but may become so under certain circumstances. Questions concerning the frequency, etiology and significance of finding a palpable spleen are raised from time to time. These factors vary with geographical distribution of tropical diseases, and other diseases prevalent in the area. We conducted this study in the department of medicine, at Combined Military Hospital Attock from Sept 2002 to Sept 2003, to find out the frequency and etiology of splenomegaly in our setup. Methods: All patients above the age of 13 years seeking advice of medical specialist in our hospital were included. History and clinical examination was performed and relevant investigations were carried out to establish the diagnosis. Results: 1400 patients were examined. Splenomegaly was present in 96 cases (6.8%). Male to female ratio was 4:1. Eighty-three percent patients had a palpable spleen of 1-5 cm while 8.5% had >10 cm. Different types of anemia constituted 29% of cases, malaria 25%, bacterial infections 18.6% and hematological malignancies 16%. Hepatitis/cirrhosis related splenomegaly was seen in 9.4% cases while 1% had tropical splenomegaly. Conclusion: Different types of anemias, malaria, bacterial infections and hematological malignancies are common causes of splenomegaly in our setup. Splenomegaly should be investigated further since all the common causes are treatable.Keywords: splenomegaly, etiology, adults.

References

Schloesser LL. The diagnostic significance of splenomegaly. Am J Med Sci 1963; 245:118-9.

Lipp WF. The clinical significance of palpable spleen. Gastroentrology 1944; 3:287-9.

Pryor DS. Tropical splenomegaly in New Guinea. Br Med J 1967; 3:825-7.

McIntyre OR, Ebaugh FG. Palpable spleen in college freshmen. Ann Intern Med 1967; 66:301-3.

Haynes BF. Lymph nodes and spleen. In: Isselbacher JI, Braunwald E, Wilson JD, Martin JB, Fauci AS, Kasper DL,(edi). Harrison’s principles of internal medicine, 13th ed. New york. Mc Graw Hill 1996:323-29.

Ali FA, Gondal KM, Ali AA. Experience of splenectomy for various medical disorders. Ann King Edward Med Coll 1997; 2(1-2): 4-5.

Ali N, Anwar M, Ayyub M, Nadeem M, Ejaz A, Qureshi AH, et al. Splenomegaly: Hematological evaluation of 100 cases. J Coll Physicians Surg Pakistan 2004; 14(7):404-6.

Lewis SM. The spleen. In: Hoffbrand AV, Lewis SM, Tuddenham EGD (eds). Postgraduate hematology. Oxford: Butterworth-Heinman 1999:323-35.

Lee GR. Spleen. In: Lee GR, Bithell TC, Foerster J, Athens JW, Lukens NJ (eds). Wintrobe’s clinical hematology 9th ed. Lea & Febiger Philadelphia London 1993:1706-10.

Bickley LS, Hoelkelman RA In:Bates guide to physical examination and history taking. 7th ed. Lippincott Williams & Wilkins1999:53-4.

Hartsock R J. Normal variation with aging of the amount of hemopoietic tissue in bone marrow from the anterior iliac crest. AM J Clin Pathol 1965; 34:326-8.

Ellis LD. Needle biopsy of bone marrow. Arch Internal Med1964; 114:213-5.

Bhalli MA, Samiullah. Falciparum malaria - A review of 120 cases. J Coll Physician Surg Pakistan 2001; 11(5): 300-3.

Hussain I, Ahmed I, Mohsin A, Muhammad Z, Shah AA. Causes of splenomegaly in Adult local population presenting at tertiary care centre in Lahore. Pakistan J Gastroenterol Mar 2002; 16(1): 12-6.

Ali N, Khattak J, Anwar M, Tariq WUZ, Nadeem M, Asif N, et al. Prevalence of Hepatitis B surface antigen and hepatitis C antibodies in young healthy adults. Pak J Pathol 2002;13(1):12-17.

Ali N, Nadeem M, Qamar A, Qureshi AH, Ejaz A. Frequency of hepatitis C virus antibodies in blood donors in Combined Military Hospital Quetta. Pak J Med Sci 2003;19(1):41-4.

Nadeem M, Ali N, Achkazai H, Ahmed I. A profile of enteric fever in adults in Quetta. Pak J Pathol 2002; 13(1): 12-7.

Lee GR. Iron deficiency and iron deficiency anemia. In: Lee GR, Bithell TC, Foerster J, Athens JW, Lukens JN (eds). Wintrobe’s clinical hematology 9th ed. Lea & Febiger Philadelphia London 1993:808-39.

Lee GR. Megaloblastic and non-megaloblastic macrocytic anemias. In: Lee GR, Bithell TC, Foerster J, Athens JW, Lukens JN(eds). Wintrobe’s clinical hematology 9th ed. Lea & Febiger Philadelphia London 1993:745-90.

Lukens JN. Acute lymphocytic leukemia In: Lee GR, Bithell TC, Foerster J, Athens JW, Lukens JN(eds). Wintrobe’s clinical hematology 9th ed. Lea & Febiger Philadelphia London 1993:1892-1919.

Downloads