Chronic Splenomegaly in a 10-Year-Old Boy

Rebecca Winderman, MD; Natalie Banniettis, MD; Simon S. Rabinowitz, MD, PhD

Disclosures

April 23, 2018

Editor's Note:
The Case Challenge series includes difficult-to-diagnose conditions, some of which are not frequently encountered by most clinicians but are nonetheless important to accurately recognize. Test your diagnostic and treatment skills using the following patient scenario and corresponding questions. If you have a case that you would like to suggest for a future Case Challenge, please contact us.

Baackground

A 10-year-old boy who emigrated from Guinea, West Africa, 6 months ago presents with splenomegaly lasting several years. His mother reports that he had lived in a small village in Guinea with his grandmother since birth. Starting at age 5 years, the patient began complaining of left-sided abdominal pain. A workup performed in Guinea was inconclusive, according to his grandmother.

He was the product of a full-term vaginal delivery and weighed 9 lb (4 kg) at birth. Although the patient has always been small for his age (third to fifth percentile), he has cognitively developed appropriately alongside his peers.

He has no significant medical history. The patient has two younger female siblings who are currently residing in the United States; both are reportedly healthy. Routine vaccinations are up to date.

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