Differential Diagnosis for 17 Year Old Male with Vomiting and Hepatosplenomegaly
Single Most Likely Diagnosis
- Infectious Mononucleosis: This condition, caused by Epstein-Barr virus (EBV), is common in adolescents and young adults. Hepatosplenomegaly and vomiting can be part of the clinical presentation, along with fever, sore throat, and lymphadenopathy.
Other Likely Diagnoses
- Viral Hepatitis: Various forms of viral hepatitis (A, B, C, D, E) can cause hepatosplenomegaly and vomiting. The diagnosis would depend on serological tests and liver function tests.
- Lymphoma: Both Hodgkin and non-Hodgkin lymphoma can present with hepatosplenomegaly and systemic symptoms like vomiting, especially if there is involvement of the liver or spleen.
- Leukemia: Acute or chronic leukemia can cause hepatosplenomegaly due to infiltration of the liver and spleen by malignant cells, and vomiting can be a symptom due to various factors including chemotherapy, infection, or direct organ involvement.
Do Not Miss Diagnoses
- Wilson's Disease: Although rare, Wilson's disease is a genetic disorder that leads to copper accumulation in the liver, causing hepatosplenomegaly and potentially life-threatening liver disease if not treated promptly. Vomiting can occur due to liver dysfunction.
- Sickle Cell Disease: Patients with sickle cell disease can experience hepatosplenomegaly due to sickling of red blood cells within the spleen and liver, leading to their enlargement. Vomiting can be a part of the acute sickle cell crisis.
- Malaria: In areas where malaria is endemic, it is crucial not to miss this diagnosis, as it can cause hepatosplenomegaly and vomiting among other symptoms, and can be life-threatening if not treated.
Rare Diagnoses
- Langerhans Cell Histiocytosis: A rare disorder in which the body accumulates too many immature Langerhans cells, part of the immune system. It can cause hepatosplenomegaly and a wide range of systemic symptoms, including vomiting.
- Gaucher's Disease: A genetic disorder causing accumulation of glucocerebroside in cells, leading to hepatosplenomegaly. While rare, it's an important consideration in the differential diagnosis of unexplained hepatosplenomegaly.
- Histiocytic Sarcoma: An extremely rare malignant tumor that can cause hepatosplenomegaly among other symptoms, including vomiting, due to liver and spleen involvement.