General weakness ? I am a 63 yr old man. i have complaints of fatigue, weakness, and increasing abdominal size. On physical examination my spleen is markedly enlarged, extending to the left iliac crest. my liver is palpated two fingerbreadths below the costal margin. my hemoglobin is 9.9, white blood count 4,500, and my platelet count is 100,000. what can cause this?