Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. It appears that she is having a very through evaluation and seems like she is in the proper place to have this work-up. I think I shall only be able to add some diagnoses that you didn t mention: -Leukemia can cause both splenomegaly and pancytopenia. -Tuberculosis can cause splenomegaly and chronic cough. -Spleen may be enlarged in child with iron-deficiency anemia, hemolytic anemia, sickle cell anemia, and other hemoglobinopathies. -Leptospirosis. -Splenic vein thrombosis. -Splenomegaly is often accompanied by hepatomegaly. Hope I have answered your query. Let me know if I can assist you further.