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Splenomegaly - Coggle Diagram
Splenomegaly
Febrile
Viral (Moderate)
Primary HIV
ADP, malaise, night sweats, diarrhea, lymphopenia, thrombocytopenia
Congenital CMV
Young mother, prematurity, Neuro signs+++ (microcephaly, inflammatory CSF, calcifications on CT), HSMG, jaundice, thrombocytopenic(THCP) purpura. Diagnosed by CMV serology (specific IgM)
Mononucleosis by EBV++++
Fever, sore throat, LNE,HSMG, Rash. Confirm by CBC (Leukocytosis with 15% mononuclear cells)+ increased trasaminases + EBV serology
Congenital Rubella
IUGR, cataract, microphthalmia, inflammatory CSF, Deafness++, Cardiovascular abnormalities, HSMG, Jaundice, THCP purpura, Skeletal signs ++++(linear translucent bands in metaphysis of long bones especially knees)
Parasitic
Visceral Leishmaniasis (Kala-Azar)
Triad: Uncontrolled fever, Extreme paleness, Huge firm painless SMG. Diagnosis: Bone marrow puncture, serology, PCR
Malaria (Moderate SMG)
Bacterial (Small SMG)
Brucellosis
Leukoneutropenia
Tuberculosis
Skin test+ Chest x ray...
Osler's endocarditis
Auscultation murmur+++
Typhoid fever
Leukopenia
Pyogenic sepsis
Congenital syphilis
Skin manifestations
Macrophage activation syndrome
Diagnostic criteria (At least five)
TG >3
Fibrinogen <1.5
Cytopenia in two lineages at least
Hemophagocytosis in BM, Spleen or LN
SMG
No neoplasia
Fever
Low NK activity
IL-2 receptor >2400
ferritin < 500
Inflammatory disorders
SLE
Juvenile chronic Arthritis (Still's disease)
Sarcoidosis
Non-Febrile
Congestive SMG
Associated to portal Hypertension ++++
Gastrointestinal bleeding
Hypersplenism (pancytopenia)
Isolated SMG
SMG of storage diseases
Niemann-Pick disease
Autosomal recessive
Type B (1-5 years)
SMG, interstitial pneumonia, NO NEURO SIGNS
Type C (neonatal cholestatic jaundice)
Sometimes death before 6 months due to liver failure, cerebellar signs (ataxia), epilepsy
Type A (infantile)
Feeding difficulties, failure to grow, SMG, pulmonary infiltrates, neuro signs (hypotonia, Blindness with cherry red spot on fundoscopy)
Diagnosis: Storage cells (pick cells) in bone marrow, sphingomyelinase deficiency in types A and B, Cholesterol esterification defect in type C
GM1 gangliosidosis (Landing disease)
Gaucher disease
Autosomal recessive
Type 1: most common, mostly in adults, no neuro signs
Type 2: before 6 months of age, neuro disorders (hypotonia, seizures, psychomotor delay), increased abdominal volume.
Mucopolysaccharidosis
Hematological disorders
Hemolytic anemia
Hereditary spherocytosis (Minkowski-Chauffard)
Enzyme deficiency (G6PD, Pyruvate kinase) Fava beans ++++
Homozygous sickle cell anemia
Autoimmune
Beta-Thalassemia
Acute Leukemia
Myeloproliferative syndromes
CML
Nutritional rickets (Von Jaksh Luzet)
Hypochromic, hypoferric anemia in young children
Isolated SMG with unidentified etiology