Differential Diagnosis for Enlarged Spleen, Elevated White Blood Cell Count, and Decreased Platelets
Single Most Likely Diagnosis
- Hematological Malignancy (e.g., Leukemia or Lymphoma): This diagnosis is likely due to the combination of an enlarged spleen (splenomegaly), elevated white blood cell count (leukocytosis), and decreased platelets (thrombocytopenia), which are common findings in hematological malignancies.
Other Likely Diagnoses
- Mononucleosis: This condition, caused by the Epstein-Barr virus, can lead to splenomegaly, leukocytosis, and thrombocytopenia.
- Hepatic Disease (e.g., Liver Cirrhosis): Liver disease can cause splenomegaly due to portal hypertension, and thrombocytopenia due to splenic sequestration.
- Autoimmune Disorders (e.g., Autoimmune Hemolytic Anemia): Certain autoimmune disorders can cause thrombocytopenia, leukocytosis, and splenomegaly.
Do Not Miss Diagnoses
- Sepsis: Although less likely, sepsis can cause splenomegaly, leukocytosis, and thrombocytopenia, and is a life-threatening condition that requires prompt diagnosis and treatment.
- Hemophagocytic Lymphohistiocytosis (HLH): This rare but life-threatening condition can cause splenomegaly, leukocytosis, and thrombocytopenia, and requires prompt recognition and treatment.
Rare Diagnoses
- Lymphoprotorative Disorders (e.g., Castleman Disease): These rare disorders can cause splenomegaly, leukocytosis, and thrombocytopenia.
- Storage Diseases (e.g., Gaucher Disease): Certain storage diseases can cause splenomegaly and thrombocytopenia due to splenic infiltration and sequestration.
- Tropical Diseases (e.g., Malaria or Tropical Splenomegaly Syndrome): These diseases can cause splenomegaly, leukocytosis, and thrombocytopenia, and should be considered in patients with a relevant travel history.