SPLEEN

1. SPLEEN

2. Professor Anwar Sheikha THE SPLEEN MAN IN THE SPLEEN LAND

9. PHAGOCYTOSIS OF PARTICUALTE MATTERS IMMUNOLOGICAL FUNCTIONS OF THE SPLEEN REGULATION OF ERYTHROPOIESIS BLOOD POOLING EMH

10. SEWERAGE DISPOSAL ﺍﻠﻣﺠﺎﺮﻱ Main Police & Security Force ﻣﺮﻛﺰﺷﺮﻄﺔ ﻮﺃﻤﻥﺍﻠﺑﻠﺪ FUNCTIONS OF THE SPLEEN POOLING اﻠﻤخزﻥ GRAVEYARD اﻠﻤقبرة ﺍﻷحتياط EMH

11. ﺍﻠﻣﺠﺎﺮﻱ ﻣﺮﻛﺰﺷﺮﻄﺔ ﻮﺃﻤﻥﺍﻠﺑﻠﺪ FUNCTIONS OF THE SPLEEN اﻠﻤقبرة ﺍﻷحتياط اﻠﻤخزﻥ

12. زبلﻮ ﺋﺎﻮﻩﺮﻮ ﭙﻮﻠﻳﺲﻮﺋﻪﻤﻧﻰ ﻨاﻮﺷﺎﺮ FUNCTIONS OF THE SPLEEN ﮔﻮﺮستان ساﻳﻠﻮ ﺍحتياط

13. SPLEEN MYSTERII ORGANUM PLENUM EXTRACTION OF MELANCHOLIC HUMOURS GREAT LAUGHTERS HAVE GRAET SPLEENS

14. HEMATOLOGIST SPLEEN GALEN’S ORGAN OF MYSTERY IMMUNOLOGIST SURGEON INFECTIOUS DISEASE PHYSICIAN ? WHO WHO SHOULD SEE A PATIENT WITH SPLENOMEGALY?

15. WILLAIM CRSOBY ROMANCING THE SPLEEN HAS BEEN A PLEASURE, BUT MARRIAGE WAS OUT OF THE QUESTION

16. SPLENOMEGALY

18. KALA AZAR HYDATID PARASITIC MALARIA TRYPANOSOMA ACUTE INFECTIONS SUBCUTE CHRONIC TYPHOID PARATYPHOID TYPHUS INEFCTIOUS MONO- NUCLEOSIS INFECTIOUS HEPATITS BRUCELLA TOXOPLASMA SEPTICEMIA S.B.E. T.B. BRUCELLA SYPHILIS HISTOPLASMA CHRONIC MENINGEAL SEPTICEMIA MILD SMG

19. LATE IN REGRESSIVE SPLENOMEGALY EARLY IN PROGRESSIVE SPLENOMEGALY MILD SMG ITP SARCOID DISORDERS WITH OCCASIONAL SPLENOMEGALY SLE MYELOMA FELTY AMYLOID CHRONIC IRON DEFICIENCY ANEMIA MEGALO- BLASTIC ANEMIA

20. LYMPHOMAS PRV ACUTE LEUKEMIA MODEARTE SMG HEMO- LYTIC ANEMIA CLL PORTAL HTN WITH CONGESTIVE SMG

21. MYELOFIBROSIS MARKED SMG CML THAL. CYSTS TUMORS GAUCHER PARASITIC TSS KALA AZAR BILHARIZIA

22. CAUSES OF SPLENOMEGALY

23. HYPERPLASIA EMH LYMPHOMA PATHOGENESIS OF SPLENOMEGALY RED CELL POOLING CONGESTIVE INFLAMMATORY STORAGE MISCELANEOUS

24. NEOPLASIA Leukemias (AL; CML; CLL) Lymphomas Metastasis EMH Thalassemia Osteopetrosis Myelofibrosis HA H. S. H.E. Thal SMG CONGE- STIVE Cirrhosis INFECTIONS Bacterial Parasitic STORAGE DISEASES Gaucher; NPD Histiocytosis Mucopolysac. V.L. TSS Bilh.

36. TSS TROPICAL SPLENOMEGALY SYNDROME MALARIAL SPLENOMEGALY

37. TSS MALARIAL SPLENOMEGALY TROPICAL SPLENOMEGALY SYNDROME

39. MAJOR DIAGNSOTC CRITERIA Gross Splenomegaly Immunity to Malaria High Serum IgM Clinical & immunological Response to Antimalarial TSS MINOR DIAGNSOTC CRITERIA Hepatic Sinusoidal lymphocytosis Normal Immune response to Antigenic Challenge Normal PHA Response Hypersplenism Lymphocytic Proliferation Occurrence in families

40. CLINICAL FEATURES OF TSS

41. PATHOGENESIS OF TSS SUPPRESSOR T- CELLS HELPER T- CELLS MALARIA PARASITE x B- LYMPHOCYTE IgM ++++ HIGH M. Wt. IMMUNE COMPLEXES SPLENOMEGALY

43. DACIE’S SYNDROME IDIOPATHIC NON-TROPICAL SPLENOMEGALY NO SYSTEMIC DISEASE GROSS SPLENO- MEGALY HYPERSPLENISM

44. DACIE’S SYNDROME Hb: 53 g/L WBC: 1,900/Ul Plat. 52,000/ul Marrow: Active * A 45 YEAR OLD FARMER * 3 MONTHS H/O TIREDNESS & NIGHT SWEATS * O/E PALLOR & GROSS SPLENOMEGALY SPLENECTOMY Weight: 1570 gm NO SPECIFIC FEATURES RADIONUCLIDE STUDIES: RCM: 13.8 ml/Kg Splenic Red Cell Pool: 28% T50 RBC Survival: 22 days Plasma Volume: 60 ml/Kg 17 YEARS LATER PATIENT WAS NORMAL WITH NORMAL CBC

45. I ADULT “NON-NEUROPATHIC” SPLENOMEGALY HYPERSPLENISM PORTAL HTN Ashkenazi Jews ↓ β – GLUCO- CEREBRO- CIDASE GAUCHER’S DISEASE II INFANTILE “NEUROPATHIC” EARLY DEATH III JEUVENILE PREDOMINANTLY NEUROPATHIC

46. RHEUMATOID ARTHRITIS SPLENOMEGALY 10% FELTY’S SYNDROME ANEMIA INFECTIONS NEUTROPENIA 1% TP PUL. HTN LEG ULCERS PIGMENTATION GALL STONES SERIOUS BACTERIAL INFECTION IS RELATIVELY UNCOMMON SPLENECTOMY DOES NOT ALTER COURSE OF FELTY’S

48. HYPERSPLENISM

49. SPLENOMEGALY HYPERCELLUALR OR NORMOCELLULAR BONE MARROW CYTOPENIA ANEMIA NEUTROPENIA THROMBO- CYTOPENIA HYPER- SPLENISM GRAVEYARD ABBATOIRE CORRECTION O F THE CYTOPENIA AFTER SPLENECTOMY

50. SPLENOMEGALY HYPERCELLUALR OR NORMOCELLULAR BONE MARROW CYTOPENIA ANEMIA NEUTROPENIA THROMBO- CYTOPENIA HYPER- SPLENISM ﮔﻮﺮﺳﺗﺎﻦ ﮔﺮﺩﻯ ﺷﻪﻫﻳﺩﺍﻦ CORRECTION O F THE CYTOPENIA AFTER SPLENECTOMY