<prompt> Tropical splenomegaly is caused by?MalariaKala azarSchistosomiasisAll of the above  <response>: Ans. d All of the above Ref. Bailey and Love 24th ed., 53.5; 26th-pg. 1091TROPICAL 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 Burkitts 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.FELTYS SYNDROME Chronic rheumatoid arthritis Mild leukopenia TRIAD Enlargement of the spleen extremene neutropenia 