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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The WBC count was Table 1.

The origin of anaemia in tropical splenomegaly syndrome. Inclusion criteria Hpyerreactive had to deal with hyperactive malaria splenomegaly or its synonymous, such as tropical splenomegaly or chronic malaria, as a main subject. Trop Med Int Health. Additional search terms used were: She received 4 months of weekly chloroquine mg, but her splenomegaly and cell counts did not improve.

Tropical splenomegaly syndrome

Previously defined as tropical splenomegaly syndrome TSSHMS has long been considered distinct from a splenomegaly directly resulting from malarial parasitaemia. Sickle cell disease and hyperreactive malarial splenomegaly HMS in young immigrants from Africa.

Intermittent therapy was also used, with quinine [ 45 ] or with chloroquine plus proguanil [ 87 ].

Recent studies of hyperreactive malarious splenomegaly tropical splenomegaly syndrome in Papua New Guinea. Finally data were extracted considering the type and duration of the treatment and when available, also data on outcome at follow-up.

There are scanty data regarding the prevalence of the syndrome in the general population. AA provided major contribution to the study design, revised critically the different malariak of the draft manuscript.

Support Center Support Center. Mac Onuigbo and Mbah [ 76 ]. Received Apr 15; Accepted May The treatments administered have been heterogeneous and do not permit recommending a first choice regimen yet, considering the lack of randomized clinical trials.


Serological and immunological investigations in patients with gross splenomegaly from the Gabon. The underlying mechanism causing anaemia is the plasma volume expansion and the spleen sequestration along with an increased haemolysis. No malarial parasites were seen on examination of a blood film but a malarial antigen test BinaxNow; Alere was positive. The surgical risks of splenectomy are often considered to be unacceptable, which leaves these patients at risk of bleeding and traumatic splenic rupture.

Serum samples from 31 healthy Sudanese donors were included as controls in the analysis. Acute Plasmodium falciparum malaria following splenectomy for suspected lymphoma in 2 patients. Films were considered negative after examination of oil fields without detection of malaria parasites. Sinusoidal lymphocytosis may spelnomegaly revealed by histologic examination of liver biopsy, but it is not specific.

Blood film microscopy was negative for malaria but serology was strongly positive. Sera from 33 patients with parasitologically confirmed mild malaria from highly endemic areas in central Sudan were used as positive controls for immunological assays. Cutoff was mean of the negative controls plus 0.

A direct correlation between the spleen size and the IgM titre has been described [ 5 hyperreactivee 8 ]. Spleen palpable more than halfway to umbilicus, but not below a line horizontally running splenomegwly it.

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

In the present study, 31 out of splenomegaly patients 9. Reference lists of all the articles identified were also examined and relevant cited references were reviewed similarly.

The tropical splenomegaly syndrome. This series is the largest 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.

The funding body had no role in the study design, in the collection, analysis and interpretation of data, in the writing of the manuscript, and in the decision to submit the manuscript for publication. Splrnomegaly malaria parasites were detected in any of the HMS patients group using microscopic examination.


The hyper-reactive malarial splenomegaly: a systematic review of the literature

These included immigrants 15 papersexpatriates ten papers or both groups one paper. Methods The search strategy was based on the following database sources: A cross-sectional study was carried out from January to December Therapy in hypereractive countries The management of HMS in non-endemic areas malarual been heterogeneous.

He was treated with a short course of mefloquine followed by 6 months of chloroquine and proguanil, after which his clinical and hematological abnormalities were resolved.

Abstract Background The hyper-reactive malarial splenomegaly syndrome HMS is a leading cause of massive splenomegaly in malaria-endemic countries.

The hyper-reactive malarial splenomegaly: a systematic review of the literature

However, using more sensitive diagnostic methods, such as polymerase chain reaction PCRthe proportion of positive cases increases [ 17 – 19 ].

The most common prescription, just as in endemic countries, was chloroquine alone [ 54838588 ], or in combination with doxycycline [ 46 ], with proguanil [ 428589 ] or with primaquine [ 90 ], or preceded by a short course of quinine [ 198388 ] or halofantrine [ 83 ].

According to some studies a male gender prevalence was noted but analysing the literature no significant gender difference was observed. Diagnostic criteria for HMS were proposed by Fakunle in [ 12 ]. Currently there is no available information on the prevalence and incidence of HMS in Sudan, apart from recently published data in the eastern part of the country which indicated that HMS is a major cause of splenomegaly in this part.