Étiologies des splénomégalies dans le service de Médecine Interne du CHU du Point G

Abstract

Splenomegaly is defined as an increase in the volume of the spleen occurring under various circumstances, the spleen being a lymphoid organ located on the path of the portal circulation. Methodology: This was a cross-sectional descriptive study with prospective data collection over 6 (six) months and retrospective data over 5.5 years, i.e. a total duration of six years from November 2018 to February 2024. Results: In our study The overall frequency of splenomegaly was 2.49%. The majority of patients were in the age group 40-49 years (27%), with a mean of 26.39 ± 7.474 years and the extremes of 15 and 50 years, the male gender represented 51.7% with a sex ratio of 1.3, the majority were housewives which represented 30.2%. The majority of patients (77.7%) had grade 1 splenomegaly according to the Hackett classification. The general signs were dominated by asthenia in 87.3%, weight loss in 71.4% and anorexia in 63.5% of our patients. In the blood hemogram, the main abnormalities found were microcytic anemia in 45.8%, thrombocytopenia in 45.8%, leukopenia and hyperleukocytosis in 27.1%, an inflammatory biological syndrome made up of CRP and ESR was positive in 87.5% and 100% respectively, TP was low in 66.7% of our patients, the myelogram had objectified the appearance of acute lymphoid leukemia in 66.7% and Appearance in favor of chronic myeloid leukemia in 33.33% among the myelograms performed, The anatomopathological examination objectified a non-Hodgkin's lymphoma in 3.2% of patients. HIV serology was positive in 34% of the serologies performed. Ultrasound demonstrated splenomegaly in the majority of our patients, i.e. a rate of 96.8% of cases. Fibroscan demonstrated stage F4 fibrosis in 15.9% of patients. Concerning the different etiologies found, infectious causes represented 65.1% (viral hepatitis), portal hypertension in 49% (cirrhosis), hematological 19% (acute leukemia and lymphoma), splenic cyst 4.8% of our patients. Conclusion: Splenomegaly is a physical sign found quite frequently in internal medicine and whose causes are numerous.