Etiological Pattern of Splenomegaly in Adults at Tertiary Care Hospital Jamshoro Sindh

BACKGROUND: Splenomegaly is usually the result of an underlying disorder; causes ranging from infections to blood cancers. Primary diseases of spleen are uncommon. Etiology of splenomegaly varies according to the geographical areas studied and depends upon the endemic, genetic and hematological diseases in the particular region. Purpose of this study was to find out the causes of splenomegaly in a tertiary care hospital representing almost entire interior of Sindh. MATERIAL & METHODS: This descriptive case series study was carried out at Department of Medicine Liaquat University Hospital Jamshoro from 1st March 2007 to 31st August 2007, over a period of six months. 100 Male and Female patients older than 13 years of age and admitted in ward with clinically enlarged spleen were selected for this study. Sampling technique was Non Probability convenient sampling. After getting informed consent from patients proforma was filled, elaborating history, important clinical findings and investigations like abdominal ultrasonography, CBC, LFT, HBsAg, Anti HCV etc were performed. Data analysis was carried out by SPSS 16 statistical software. RESULTS: Among 100 patients with splenomegaly there was majority of male patients i.e.60%.The most common cause of splenomegaly found in our study was chronic liver disease i.e. 64% followed by malaria 16%, and hematological malignancies 14%. There were 2% patients found with enlarged spleen due to tuberculosis, remaining 4% comprised 1% each of enteric fever, infective endocarditis, CCF and SLE. Among the patients of hematological malignancies there were 9% patients of leukemia, 4% of lymphoma and 1% of myelofibrosis. As to the 9% leukemic patients, 4% suffered from Chronic Myeloid Leukemia, 3% from Acute Myeloid Leukemia and 2% from Chronic Lymphocytic Leukemia. Most common associated clinical sign was anemia demonstrated in 77% of patients. CONCLUSIONS: Chronic liver disease is the most common that leads to splenomegaly in population studied. Malaria and hematological malignancies appear to be the major contributors for splenomegaly. Finding of enlarge spleen needs clinical work up to reach the correct diagnosis.