compared with a rate of 6–20% in cerebral malaria. Data on the prevalence of HMS is scant, but in areas with intense transmission of malaria. malarial splenomegaly. SIR—Hyper-reactive malarial splenomegaly (HMS) is a form of severe malaria, with a mortality rate that exceeds 50%,1,2 compared with . ABSTRACT. Hyper-reactive malarial splenomegaly (HMS) or Tropical splenomegaly syndrome(TSS), occurs in areas of high transmission of.

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Four of the seven cases that we reported responded to antimalarial therapy.

A year-old man, who had recently migrated to the United Kingdom from Sierra Leone, was referred to a hospital with abdominal pain. Hyperreactive malarial splenomegaly in Europeans.

The relationship between the parasite rate and the spleen size varied with age: Cutoff was determined hy;erreactive the mean plus 2 standard deviations of the optical density OD values obtained with sera from 10 European donors with no history of malaria exposure.

Long term results of splenectomy. The patients with enlarged spleens were followed up for 3 months. Thirty-three sera from parasitologically confirmed P. Splenectomy, associated with high mortality, should be strictly limited to cases not responding to medical treatment. Immunodiagnostic studies in tropical splenomegaly syndrome in Uganda.

Hyperreactive Malarial Splenomegaly Syndrome—Can the Diagnostic Criteria Be Improved?

Trop Med Int Health. A year-old Nigerian man presented with lethargy and abdominal pain.

Serum samples from 31 healthy Sudanese donors were included spleenomegaly controls in the analysis. Most patients had lived for at least five years in an endemic area. Five years later, his symptoms returned.


This view does not hold any longer. Chloroquine seems to still be partially effective, even if P.

Splenomegalh seems to be associated with a high mortality; however, the natural history of HMS is not well documented. A year-old Somalian woman, resident in the United Kingdom for 6 months, presented with abdominal pain and fever.

This suggests that Plasmodium is present, albeit often at sub-microscopic parasite density. Sera from 33 patients with parasitologically confirmed mild malaria from highly endemic areas in central Sudan gyperreactive used as positive controls for immunological assays.

Other regimens used for long-term treatment were proguanil [ 678586 ], mefloquine [ 91 ] or quinine plus doxycycline [ 17 ]. The objective of the study was to determine the incidence of HMS in patients who reported to the Omdurman Tropical Diseases Hospital OMTDH in Sudan and to investigate the basic laboratory and immunological characteristics of this condition in these patients.

Tropical splenomegaly syndrome in Ceylon. The choice of drug may have been guided by the suggestion from the early s that chloroquine has an immunological effect on HMSS in addition to its antimalarial properties.

Tropical splenomegaly syndrome

There are scanty data regarding the prevalence of the syndrome in the general population. This series is the splenomebaly described in a non-endemic setting, and the cases illustrate some of the challenges in the diagnosis and management of such a poorly understood condition.


HMS Patients The age of patients ranged from 10 to 70 years; mean age was years. Histologic examination of liver biopsy showed pipestem fibrosis. She was commenced on chloroquine mg weekly and proguanil mg OD.

Tropical splenomegaly syndrome – Wikipedia

Reference lists of all the articles identified were also examined and relevant cited references were reviewed similarly. Author information Article notes Copyright and License information Disclaimer. In five studies the syndrome was also diagnosed in absence of raised IgM [ 132375253 ].

Fakunle and Greenwood [ 64 ]. Papers detected wereof which 89 were included. However, the liver tended to progressively enlarge, probably related to persistence of the antigenic stimulus [ 95 ].

Long-term proguanil therapy in idiopathic tropical splenomegaly. However, a solitary trophozoite of Plasmodium falciparum was noted on a third film, performed 1 month after her initial presentation. AA provided major contribution to the study design, revised critically the different versions of the draft manuscript. Hyperreactive malarial splenomegaly in Europeans: Results Papers detected wereof which 89 were included. Haemolytic episodes associated with acute febrile illness or pregnancy can precipitate the course of HMS and, on occasion, be associated with sudden death.

Hyperreactive malarial splenomegaly syndrome in a European patient.