Figure 3.
Algorithms for a non-evidence based diagnostic approach toward a pediatric or adolescent patient presenting with splenomegaly on physical examination. Diagnostic steps are grouped into 1st line, 2nd line, and 3rd line approaches. The extensive list of differential diagnoses excludes more detailed information in this flow chart for which the reader is kindly referred to the text and to Table 3 of this review. ALPS, autoimmune lymphoproliferative syndrome; CRP C, reactive protein; EMA, eosin-5'-maleimide; FMF, familial Mediterranean fever; Hb, hemoglobin; HLH, hemophagocytic lymphohistiocytosis; juv., juvenile; LDH, lactate dehydrogenase; MRI, magnetic resonance imaging; PCR, polymerase chain reaction; SLE, systemic lupus erythematosus; SSc, systemic sclerosis.