Clinical features

• Typically non-specific symptoms: lethargy, malaise, fatigue, weight loss and dyspnoea.

• 15% present with infections, often atypical organisms due to mono-cytopenia.

• ~30% have recurrent infection; 30% bleeding or easy bruising.

• Splenomegaly in 80% (massive in 20-30%), hepatomegaly in 20%.

• Pancytopenia may be an incidental finding on a routine FBC.

• Vasculitic polyarthritis and visceral involvement similar to polyarteritis nodosa occurs in some patients with HCL.

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