General MedicineHaematology
Splenomegaly Workup
Categorise (massive, moderate, mild) — different differentials; targeted bloods + imaging + bone marrow if needed.
Source: BSH; BMJ Best Practice
Step 1 of ~3
info
Categorise + Differentiate
Splenomegaly: enlarged spleen (typically >12 cm on USS).
Categories by size:
• Massive (>20 cm or palpable across midline / into pelvis): chronic myeloid leukaemia, myelofibrosis, chronic lymphocytic leukaemia, hairy cell leukaemia, lymphoma, malaria (chronic), kala-azar, Gaucher's disease, polycythaemia vera.
• Moderate (12–20 cm): infiltrative (lymphoma, leukaemia, myelofibrosis), portal hypertension (cirrhosis), thalassaemia.
• Mild (<12 cm): infectious (mononucleosis, viral hepatitis, brucella, malaria), portal HTN (cirrhosis), connective tissue disease (RA — Felty's syndrome, SLE), autoimmune haemolytic anaemia.
Assess: associated lymphadenopathy, hepatomegaly, ascites, B symptoms, jaundice, ecchymoses, pallor (anaemia).
Related
Curated clinical cross-links plus same-class fallbacks.
Drugs
- Alclometasone dipropionate · Mild–moderate topical corticosteroid
- Codeine Phosphate (Orthopaedic — Mild-Moderate Pain) · Opioid Analgesic — Weak (Prodrug)
- Phenylephrine · Alpha-1 Adrenergic Agonist (Pure Vasoconstrictor)
- Inclisiran · PCSK9-targeted siRNA
- Hydrocortisone (Topical) · Mild Topical Corticosteroid
- Tretinoin (Topical) · Topical Retinoid — Acne / Photoaging
Pathways
- Sepsis Screening and Sepsis Six · UK Sepsis Trust; NICE NG51; Surviving Sepsis Campaign 2021
- Unintentional Weight Loss Workup · NICE NG12; BSG
- Chronic Fatigue Workup · NICE NG206; BMJ Best Practice
- Lymphadenopathy Workup · NICE NG12; BMJ Best Practice
- Pre-op Medical Clearance · NICE NG45; ESC 2022
- Secondary Hypertension Workup · NICE NG136; ESH 2023
Decision support only. Always apply local guidelines and clinical judgement.