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True idiopathic splenomegaly--a distinct clinical entity
Scandinavian Journal of Haematology
|October 1, 1986
Summary
Idiopathic splenomegaly, or enlarged spleen, can occur in young men following cytomegalovirus infection. This condition is benign and should be considered in diagnosing unexplained enlarged spleens.
Area of Science:
- Internal Medicine
- Hematology
- Virology
Background:
- Splenomegaly, or enlarged spleen, is a common clinical finding.
- Determining the etiology of splenomegaly in asymptomatic individuals can be challenging.
- Previous studies have explored various causes of splenomegaly, but idiopathic cases persist.
Purpose of the Study:
- To investigate the cause of splenomegaly in 10 asymptomatic young male patients.
- To identify potential etiological factors for unexplained enlarged spleens.
- To propose a diagnostic framework for idiopathic splenomegaly.
Main Methods:
- Clinical examination and patient history.
- Comprehensive laboratory investigations including blood counts, clotting studies, and serological tests for infections (malaria, Ebstein Barr Virus, cytomegalovirus).
- Biopsies of liver, rectum, and bone marrow aspirates.
Main Results:
- Routine investigations and specific disease screenings were unrevealing in all patients.
- Five out of ten patients tested positive for IgG antibodies against cytomegalovirus (CMV).
- No evidence of blood dyscrasias, clotting disorders, Gaucher's disease, or bilharzia was found.
Conclusions:
- Asymptomatic splenomegaly in these patients may be linked to a severe antigenic response to prior cytomegalovirus infection.
- 'True Idiopathic Splenomegaly' is proposed as a diagnosis for benign splenic enlargement of undetermined origin.
- This diagnosis should be considered in the differential diagnosis of asymptomatic splenomegaly.