PRINCIPLES: @entity6118 can be defined by @entity882 and/or @entity1398 resulting from blood cell sequestration in an enlarged spleen. In multimorbid @entity1 the differential diagnosis of @entity1503 is challenging and currently there is no established test for diagnosing @entity6118 . METHODS: The epinephrine stimulation test (EST) measures changes in platelets, neutrophil counts and spleen size following a subcutaneous epinephrine injection. We retrospectively analysed the results of EST in 228 @entity1 . RESULTS: Increases in neutrophils and platelets after epinephrine injection were significantly greater in @entity1 with enlarged than in @entity1 with normal size spleens. Using cutoffs of low, intermediate and high confidence EST was positive in 69.8% vs. 41.3% (low confidence), 49.6% vs. 17.4% (intermediate confidence) and 38.8% vs. 10.9% (high confidence) in @entity1 with enlarged vs. normal size spleens. Changes in platelet and neutrophil counts correlated with each other and with changes in spleen size, confirming cell release from the spleen during EST. When stratified according to the underlying diagnosis, @entity1 with @entity409 had the strongest response to EST, @entity1 with malignant @entity66 the weakest. In addition the response to EST was significantly related to changes in platelet and neutrophil counts after splenectomy, confirming the validity of our test. No serious side effects occurred during EST. CONCLUSION: When used in a large @entity1 cohort, EST is a safe and simple diagnostic test. In this exploratory study EST is of value in evaluating @entity1 with @entity1503 and a positive EST argues strongly for @entity6118 . Future studies should prospectively evaluate EST for the management of @entity1 with @entity381 .

Diagnosis of XXXX with the epinephrine stimulation test - 23 years of experience at a tertiary care hospital.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity66 :: ('MESH:D004194', 'Disease') :: ['haematological diseases'] @entity882 :: ('MESH:D013921', 'Disease') :: ['thrombocytopenia'] @entity409 :: ('MESH:D008107', 'Disease') :: ['liver disease'] @entity1503 :: ('MESH:D006402', 'Disease') :: ['cytopenia'] @entity1398 :: ('MESH:D009503', 'Disease') :: ['neutropenia'] @entity381 :: ('MESH:D013163', 'Disease') :: ['splenomegaly'] @entity6118 :: ('MESH:D006971', 'Disease') :: ['hypersplenism', 'Hypersplenism']
@entity6118 :: (MESH:D006971,Disease) :: ['hypersplenism']
