Tropical splenomegaly is caused by?

Ans. d (All of the above) (Ref. Bailey and Love 24th ed., 53.5; 26th-pg. 1091)TROPICAL SPLENOMEGALY: Massive enlargement of the spleen occurs frequently in the tropics, for example in -# Malaria (especially in children),# Kalaazar and# Schistosomiasis.# Tropical splenomegaly may be associated with anemia due to shortened red cell life and thrombocytopenia due to splenic sequestration of platelets, which respond to splenectomy. Splenectomy is indicated for those disabled by anemia or by the weight of an enormous spleen. Splenectomy reduces immunity to malaria and therefore antimalarial chemotherapy (e.g., proguanil) should follow splenectomy in malaria-endemic areas and be maintained for life.Also Remember:CHRONIC COMPLICATIONS OF MALARIA# Tropical splenomegaly# Malarial nephropathy (membranous GN)# Burkitt's LymphomaHYPERSPLENISM DUE TO PORTAL HYPERTENSION# Splenomegaly invariably accompanies portal hypertension.# This splenic enlargement results in thrombocytopenia (due to splenic sequestration of platelets) and granulocytopenia.# These are permanently relieved when splenectomy accompanies operation for the relief of portal hypertension.# Shunt surgery alone does not have the same effect.FELTY'S SYNDROME# Chronic rheumatoid arthritis# Mild leukopenia (TRIAD)# Enlargement of the spleen (extremene neutropenia)