Sidransky E. Disco Med. 2012;14:273-81; Grabowski GA. Lancet. 2008;372:1263-71;
Mehta A. Eur J Intern Med. 2006;17:S2-5;Kaplan P, et al. Arch Pediatr Adolesc Med. 2006;160:603-8.
Hepatosplenomegaly is very common in these patients, often it is painless enlargement causing abdominal distention. This is often associated with cytopenia, thrombocytopenia, anemia, leukopenia, can be associated with bruising and bleeding, it can lead to chronic fatigue and failure to perform at school and in sport, loss of appetite because of massive enlargement of the spleen compressing the stomach and resulting in early satiety, and rarely in mild abnormality in liver function tests.