September 25, 2019


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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Investigation of familial segregation of hyperreactive malarial splenomegaly in Kumasi, Ghana. However, no prophylaxis was administered during the different treatments.

Evolutive visceral malaria and hyperimmune palustral splenomegaly: In six studies out of 21 a short course of treatment as for an acute malaria episode was administered [ 174243668182 ]. J Trop Med Hyg. Histologic examination of liver biopsy showed pipestem fibrosis. Methods The search strategy was based on amlarial following database sources: Journal of Tropical Medicine. Author information Article notes Copyright and License information Disclaimer.

Tropical splenomegaly syndromealso known as hyperreactive malarial splenomegalyoccurs due immunological over-stimulation to repeated attacks of malarial infection over a long period of time.

However some key points are identifiable.

Journal of Tropical Medicine

Author information Article notes Copyright and License information Disclaimer. He was then prescribed a prolonged course of atovaquone—proguanil one tablet ODwith no improvement.

SL contributed to the study design, performed mslarial systematic review, wrote the first version of the manuscript. Epidemiology, malarial antibody and immunoglobulin levels. The tropical splenomegaly syndrome. In other papers, the exclusion of other causes of splenomegaly in an endemic area was sufficient to consider a patient as affected by HMS [ 5657 ].


The clinical outcome at follow-up was favourable for all patients who remained in Europe and presented at follow-up. Am J Trop Med Hyg. From Wikipedia, the free encyclopedia. Bates I, Bedu-Addo G. Tropical splenomegaly syndrome in a nontropical setting.

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

It reflects the view that the syndrome tends to evolve even though malaria parasites are no longer present in blood. Low-grade parasitaemias and cold agglutinins in patients with hyper-reactive malarious splenomegaly and acute haemolysis. Chronic malaria with HMSS and hemolysis; possible reinfection. Splenomegaly likely related to cirrhosis. Splenectomy Splenectomy in HMS is generally suggested for patients with huge splenomegaly and disabling symptoms, who do not respond to medical treatments [ 2993 ].

The mean Hb level was. In the present study, 31 out of splenomegaly patients 9. The hyper-reactive malarial splenomegaly syndrome HMS is a leading cause of massive splenomegaly in malaria-endemic countries. Long-term proguanil therapy in idiopathic tropical splenomegaly. HMS Patients The age of patients ranged from 10 to 70 years; mean age was years. Table 3 Treatment outcome: Moreover, a direct correlation between the splenomegaly class and the IgM level has been demonstrated, suggesting a continuum in the syndrome evolution [ 42 ].

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 splenonegaly HMS is a major cause of splenomegaly in this part. Analysis of cases. Recent studies of hyperreactive malarious splenomegaly tropical splenomegaly syndrome in Papua New Guinea.

DB provided major contribution to the study design, performed the systematic review, revised critically the dplenomegaly versions of the draft manuscript.


After 8 months of treatment with chloroquine, his splenomegaly was unchanged. The technical assistance of the staff of Omdurman Tropical Medicine Hospital is greatly acknowledged.

According to historical data, the syndrome is often fatal if left untreated [ 20 ]. Pubmed, EmBase, Scopus, with no limitation as for the year of publication.

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

Acute Plasmodium falciparum malaria following splenectomy for suspected lymphoma in 2 patients. The prophylactic regimen halved the mortality rate over ten years compared malarual untreated patients [ 79 ]. To receive news and publication updates nyperreactive Journal of Tropical Medicine, enter your email address in the box below. He had experienced febrile episodes with occasional jaundice every 2—3 months for many years and these had been treated in Sierra Leone with empirical antibiotics and antimalarial therapy.

Some authors have hypothesized that HMS could be considered as a pre-malignant state that could evolve to chronic lymphocytic or hairy cell leukaemia or splenic lymphoma with villous lymphocytes, as a result of a multi-step process with a single clone selection in a set of yhperreactive polyclonal expansion of lymphocytes [ 21 – 23 ].

Examination showed gross 25 cm splenomegaly. N Engl J Med. Cook GC, Zumla A, editors.

Malaria and the tropical splenomegaly syndrome in New Guinea.