Hematological evaluation of splenomegaly.
OBJECTIVE
To find out the relative frequency of clinical conditions associated with splenomegaly that require hematological evaluation in our set up.


METHODS
Cross sectional study.


METHODS
Combined Military Hospital, Quetta, Balochistan, from July 2000 to July 2003.


METHODS
Patients of either gender and all age groups with palpable spleen were included. Patients with splenomegaly due to liver disease, malarial parasites on thick or thin blood film, positive Widal test, or positive blood cultures were excluded from study. Patients were initially evaluated with clinical history, microscopic examination of blood smear, and blood counts. Depending upon provisional diagnosis bone marrow examination or investigations for hemolytic anemia were performed.


RESULTS
One hundred patients were received. Seventy-eight patients were adults and 22 patients were of pediatric age group. In the adults, hematological malignancies were seen in 37%, malarial parasites in bone marrow in 20.5%, megaloblastic anemia in 13%, bacterial infections in 9%, hemolytic anemia in 9%, tropical splenomegaly in 5%, and positive bone marrow culture for salmonella in 6.5%. In children, hematological evaluation revealed hematological malignancies in 18%, beta thalassaemia in 55%, other hemolytic anemias in 13.5%, congenital sideroblastic anemia in 4.5%, and storage disorder in 9%.


CONCLUSIONS
Hematological workup is informative in most of the cases. Bone marrow examination is the key investigation, hematological malignancies constituted 37% of the adult and 18% of pediatric age group patients. Hemolytic anemia constituted 68% of pediatric age group.
Department of Pathology, Combined Military Hospital, Attock, Pakistan. nmjrm@hotmail.com
Nadir
N
Ali
Masood
M
Anwar
Mohammad
M
Ayyub
Mansoor
M
Nadeem
Aamir
A
Ejaz
Ayaz Hussain
AH
Qureshi
Mohammad Ashraf
MA
Qamar
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000743:Anemia, Hemolytic / Q000175:diagnosis / Q000453:epidemiology*; D001856:Bone Marrow Examination; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D019337:Hematologic Neoplasms / Q000175:diagnosis / Q000453:epidemiology*; D006403:Hematologic Tests / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000453:epidemiology; D015995:Prevalence; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D013163:Splenomegaly / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*