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CAUSES OF HEPATOMEGALY
HEPATOMEGALY
Massive:
        Metastases
        Alcoholic liver disease with fatty infiltration
        Myeloproliferative disease
        Right heart failure
        Hepatocellular cancer
Moderate:
        Haemochromatosis
        Haematological disease - e.g. chronic leukaemia, lymphoma, myeloproliferative disorders
        Fatty liver - e.g. secondary to diabetes mellitus
        Infiltration - e.g. amyloid
Mild:
        Hepatitis
        Biliary obstruction
        Hydatid disease
        Human immunodeficiency virus (HIV) infection
Firm and Irregular Liver
        Hepatocellular carcinoma
        Metastatic disease
        Cirrhosis
        Hydatid disease, granuloma (e.g. sarcoid), amyloid, cysts, lipoidoses
Tender Liver
        Hepatitis
        Rapid liver enlargement

>        Right heart failure
>        Budd-Chiari Syndrome (hepatic vein thrombosis)

        Hepatocellular cancer
        Hepatic abscess
        Biliary obstruction/cholangitis

CAUSES OF SPLENOMEGALY
Massive                                                                Moderate
        Chronic myeloid leukaemia                                          Portal hypertension
        Myelofibrosis                                                          Lymphoma
        Malaria                                                              Leukaemia (acute or chronic)
        Kala azar                                                            Thalassaemia
        Primary lymphoma of spleen                                  Storage diseases e.g. Gaucher’s disease
Small
     Other myeloproliferative disorders
>        Polycythaemia rubra vera (PCV)
>        Essential thrombocythaemia (ET)

        Haemolytic anaemia
        Infection:

>        Viral (e.g. infectious mononucleosis, hepatitis)
>        Bacterial (e.g. infective endocarditis)
>        Protozoal (e.g. malaria)
     Connective tissue diseases:
>        Rheumatoid arthritis
>        Systemic lupus erythematosus
>        Polyarteritis nodosa
     Infiltrations:
>        Amyloid
>        Sarcoid

        Megaloblastic anaemia (rarely)
        Secondary carcinomatosis is a rare cause of splenomegaly
CAUSES OF HEPATOSPLENOMEGALY
        Chronic liver disease with portal hypertension (therefore signs of liver disease/portal hypertension are critical features in assisting with DDx of hepatosplenomegaly)
        Haematological disease:

>        Lymphopopliferative disorders: Hodgkins lymphoma, NHL, ALL
>        Myeloproliferative disorders: AML, CML/CGL
>        Other : pernicious anaemia, sickle cell, thalassaemia

        Infiltration: amyloid, sarcoid Gauchers
        Infection: viral hepatitis, EBV, CMV
        Connective tissue disease: SLE
        Metabolic:

>        Acromegaly
>        Thyrotoxicosis

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