{"id":4445,"date":"2022-05-03T11:47:20","date_gmt":"2022-05-03T10:47:20","guid":{"rendered":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/splenomegaly\/"},"modified":"2026-04-20T10:08:41","modified_gmt":"2026-04-20T09:08:41","slug":"splenomegaly","status":"publish","type":"page","link":"https:\/\/apps.nhslothian.scot\/refhelp\/guidelines\/haematology\/splenomegaly\/","title":{"rendered":"Splenomegaly"},"content":{"rendered":"\n<h4 class=\"wp-block-heading\">Definition<\/h4>\n\n\n\n<p>Splenomegaly denotes a palpable spleen, or an enlarged spleen detected by USS or CT \/ MRI scan.<\/p>\n\n\n\n<p>Presentation ranges from a massively enlarged spleen to mild splenomegaly only detected on imaging. Increasingly, splenomegaly is noted as an incidental finding in imaging studies performed for other reasons.<\/p>\n\n\n\n<p>Isolated splenomegaly is a feature of a number of diverse problems including:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>infections such as malaria and infective endocarditis;<\/li>\n\n\n\n<li>chronic liver disease; autoimmune disorders including rheumatoid arthritis, Felty\u2019s syndrome and SLE;<\/li>\n\n\n\n<li>Gaucher\u2019s disease and sarcoidosis.<\/li>\n<\/ul>\n\n\n\n<p>Haematological causes include autoimmune haemolysis, hereditary spherocytosis, myeloproliferative disorders, myelofibrosis, leukaemias and lymphomas.<\/p>\n\n\n\n<p><strong>C.M &amp; L.W 31-07-23<\/strong><br><\/p>\n\n\n\n<div class=\"wp-block-getwid-tabs\" data-active-tab=\"0\"><ul class=\"wp-block-getwid-tabs__nav-links\"><\/ul>\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Referral Guidelines<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h4 class=\"wp-block-heading\">Who to refer:<\/h4>\n\n\n\n<p>Those with<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Splenomegaly &gt;15cms\u2013 majority likely to have a haematological disorder<\/li>\n\n\n\n<li>Significant additional systemic symptoms: weight loss, fever, alcohol induced pain<\/li>\n\n\n\n<li>Associated nodal enlargement<\/li>\n\n\n\n<li>Increased reticulocyte count and\/or DCT positive<\/li>\n\n\n\n<li>Abnormal FBC either cytopenias or cytoses, lymphocytosis or leucoerythroblastic blood film<\/li>\n<\/ul>\n\n\n\n<h4 class=\"wp-block-heading\">Who not to refer:<\/h4>\n\n\n\n<p>Those with chronic liver disease and portal hypertension (consider hepatology instead)<\/p>\n\n\n\n<h4 class=\"wp-block-heading\">How to refer:<\/h4>\n\n\n\n<p>SCI Gateway to Department of Haematology WGH or SJH.<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Primary Care Management<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<h3 class=\"wp-block-heading\">Primary care investigations<\/h3>\n\n\n\n<ul class=\"wp-block-list\">\n<li>FBC<\/li>\n\n\n\n<li>Blood film<\/li>\n\n\n\n<li>CRP<\/li>\n\n\n\n<li>Reticulocyte count, if raised check Direct Antiglobulin Test (DAT) test<\/li>\n\n\n\n<li>LFTs and LDH<\/li>\n\n\n\n<li>Viral serology for EBV (IgM),HIV &amp; Hepatitis viruses<\/li>\n\n\n\n<li>Quantitative immunoglobulins<\/li>\n<\/ul>\n\n\n\n<p><em>If additional clinical features<\/em> to suggest a diagnosis of SLE, RA or other connective tissue disorder check CCP, ANA, dsDNA (if ANA positive).<\/p>\n<\/div><\/div>\n\n\n\n<div class=\"wp-block-getwid-tabs__nav-link\"><span class=\"wp-block-getwid-tabs__title-wrapper\"><a href=\"#\"><span class=\"wp-block-getwid-tabs__title\">Resources and Links<\/span><\/a><\/span><\/div><div class=\"wp-block-getwid-tabs__tab-content-wrapper\"><div class=\"wp-block-getwid-tabs__tab-content\">\n<p><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Definition Splenomegaly denotes a palpable spleen, or an enlarged spleen detected by USS or CT \/ MRI scan. Presentation ranges from a massively enlarged spleen to mild splenomegaly only detected on imaging. Increasingly, splenomegaly is noted as an incidental finding in imaging studies performed for other reasons. Isolated splenomegaly is a feature of a number<\/p>\n","protected":false},"author":2,"featured_media":0,"parent":3981,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[272],"class_list":["post-4445","page","type-page","status-publish","hentry","category-splenomegaly"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"NHS Lothian","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/nhs-lothian\/"},"rttpg_comment":0,"rttpg_category":" <a href=\"https:\/\/apps.nhslothian.scot\/refhelp\/category\/haematology\/splenomegaly\/\" rel=\"tag\">Splenomegaly<\/a>","rttpg_excerpt":"Definition Splenomegaly denotes a palpable spleen, or an enlarged spleen detected by USS or CT \/ MRI scan. Presentation ranges from a massively enlarged spleen to mild splenomegaly only detected on imaging. Increasingly, splenomegaly is noted as an incidental finding in imaging studies performed for other reasons. Isolated splenomegaly is a feature of a number","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4445","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=4445"}],"version-history":[{"count":9,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4445\/revisions"}],"predecessor-version":[{"id":27697,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4445\/revisions\/27697"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/3981"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=4445"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=4445"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}