Clinical symptoms and signs

• 30% asymptomatic at diagnosis; present after routine FBC.

• Fatigue, lethargy, weight loss, sweats.

• Splenomegaly in >75%; may cause (L) hypochondrial pain, satiety and sensation of abdominal fullness.

• Gout, bruising/bleeding, splenic infarction and occasionally priapism.

• Signs include moderate to large splenomegaly (40% >10cm), hepatomegaly (2%), lymphadenopathy unusual.

• Occasional signs of leucostasis at presentation.

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