HNY Policy and Pathway Repository - North Yorkshire

Spleen >13 cm

NB: Spleen increases with height. On average increases in length by 0.2 cm for every inch >6 ft

• B symptoms
  • weight loss >10% over 6 months
  • drenching sweats,
  • unexplained fever >38°C
• Cytopenias
• Paraprotein
• Lymphadenopathy
• High haemoglobin or increased platelet count
• Evidence of haemolysis
• High WBC
• Leuco‑erythroblastic blood film

Causes

• Infections – Viral (HIV, EBV, CMV) and parasitic
• Alcohol
• Liver disease
• Cardiac failure
• Autoimmune
• Lymphoproliferative disorders
• Myeloproliferative disorders (such as CML or myeloproliferative disorders)
• Haemolysis

Refer to Haematology on urgent (suspected cancer) pathway if:

• B symptoms
  • weight loss >10% over 6 months
  • drenching sweats,
  • unexplained fever >38°C
• Cytopenias
• Paraprotein
• Lymphadenopathy
• High haemoglobin or increased platelet count
• Evidence of haemolysis
• High WBC
• Leuco‑erythroblastic blood film
   

If no obvious cause refer to Haematology:

• If criteria for urgent referral not met search for causes, especially liver disease/cirrhosis.

• Harrogate and District