What are the referral criteria for a patient with unexplained splenomegaly to secondary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 16 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Consider a very urgent referral (for an appointment within 48 hours) for specialist assessment in patients with unexplained splenomegaly, especially if associated with symptoms such as fever, night sweats, shortness of breath, pruritus, or weight loss .

In children and young people, unexplained splenomegaly warrants consideration of a very urgent referral for specialist assessment .

Referral should be considered in the context of associated symptoms and clinical features, with particular attention to signs suggestive of haematological malignancies such as non-Hodgkin's lymphoma or leukaemia .

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