Differential Diagnosis for Splenomegaly and Lactic Acidosis
- Single Most Likely Diagnosis
- Lymphoma: This is a common cause of splenomegaly, and lactic acidosis can occur due to tumor lysis syndrome or sepsis in the setting of immunocompromised state.
- Other Likely Diagnoses
- Sepsis: Splenomegaly can be seen in the setting of sepsis, particularly with certain infections like endocarditis or typhoid fever, and lactic acidosis is a common complication of severe sepsis.
- Liver Cirrhosis: Patients with cirrhosis can develop splenomegaly due to portal hypertension, and lactic acidosis can occur due to impaired hepatic function or secondary sepsis.
- Hematological Disorders (e.g., Myeloproliferative Neoplasms): Conditions like polycythemia vera or myelofibrosis can cause splenomegaly, and lactic acidosis may occur due to increased cell turnover or associated sepsis.
- Do Not Miss Diagnoses
- Sickle Cell Crisis: Although less common, sickle cell disease can cause splenomegaly and lactic acidosis due to vaso-occlusive crisis and tissue ischemia.
- Malaria: Certain types of malaria, like Plasmodium falciparum, can cause splenomegaly and lactic acidosis due to severe infection and organ dysfunction.
- Rare Diagnoses
- Gaucher's Disease: A rare genetic disorder that can cause splenomegaly due to accumulation of glucocerebroside, and lactic acidosis may occur due to associated hematological abnormalities or secondary infections.
- Histiocytosis: A group of rare disorders characterized by abnormal proliferation of histiocytes, which can cause splenomegaly and lactic acidosis due to tissue infiltration and organ dysfunction.