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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Tropical splenomegaly syndrome – Wikipedia

Other regimens used for long-term treatment were proguanil [ 678586 ], mefloquine [ 91 ] or quinine plus doxycycline [ 17 ]. The mechanism of anaemia in tropical splenomegaly. However, slpenomegaly prophylaxis was administered during the different treatments.

Diagn Microbiol Infect Dis.

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

However, in no case a normalization of the spleen size was observed. This particular aspect was described in a study showing a progressive enlargement of the liver after splenectomy in a patient with negative thick blood films.

During the study period, 31 out of 9. Diagnostic criteria for HMS were proposed by Fakunle in [ 12 ]. An initial amplification of the outer regions of the two genes was followed by a nested PCR with allelic family specific primer pairs [ 13 ]. J Natl Med Assoc. Sera from 33 patients with parasitologically confirmed mild malaria from highly endemic areas in central Sudan were used as positive controls for immunological assays.


Finally data were extracted considering the type and duration of the treatment and when available, also data on outcome at follow-up. She was commenced on chloroquine mg weekly and proguanil mg OD. HMS Patients The age of patients ranged from 10 to 70 years; mean age was years. Films were considered negative after examination of oil fields without detection of malaria parasites.

Polymerase Chain Reaction PCR PCR analysis was carried out on samples collected from all patients for detection of malaria parasites; the primers specific for the polymorphic regions block 2 of merozoite surface protein 1 MSP1 and block 3 of MSP2 were designed and described previously.

Chronic splenomegaly in Nairobi, Kenya. The diagnosis of HMS was based mainly on the standard criteria for diagnosis of HMS [ 12 ] which included physical examination hyperrdactive as massive splenomegaly and exclusion of other common causes of huge spleen, that is, hyperrexctive of hepatitis or alcohol abuse, exposure to schistosomiasis or malarrial, a family history of haemoglobinopathies or clinical evidence of fever, jaundice, lymphadenopathy, hepatomegaly, and portal hypertension.

Retrieved from ” https: Table 3 Treatment outcome: A case of hyper-reactive malarial splenomegaly. Physical examination usually reveals massive splenomegaly of the spleen often extending across the midline to the right side of the abdomen or downward to the left iliac fossa.

Cryoglobulinaemia in tropical splenomegaly syndrome. Hyperreactive malarial splenomegaly in Venezuela. Inclusion criteria Articles had to deal with hyperactive malaria splenomegaly or its synonymous, such as tropical splenomegaly or chronic malaria, as a main subject. Hyper-reactive malarial splenomegaly in a patient with human hyperrfactive virus. The most common prescription, just as in endemic countries, was chloroquine alone [ 54838588 ], or in combination with doxycycline [ 46 byperreactive, with proguanil [ 428589 ] or with primaquine [ 90 ], or preceded by a short course of quinine [ 198388 ] or halofantrine [ 83 ].


This study was carried out in Khartoum, Sudan.

Another approach to the diagnosis of HMS was a combination of major and minor criteria. Most other authors opted for long-term treatment following, in some cases only, a short anti-malarial course [ 8485 ].

However, a solitary trophozoite of Plasmodium falciparum was noted on a third film, performed 1 month after her initial presentation.

The most recent one was carried out in Sudan in and reported, after a three-month therapy, a complete normalization of the spleen size in 14 patients out of 21 [ 69 ].

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Tropical splenomegaly syndrome

A synthetic splenomeagly derived from different regions of the circumsporozoite protein was used in this study. Splenectomy in HMS is generally suggested for patients with huge splenomegaly and disabling symptoms, who do not respond to medical treatments [ 2993 ].

Immunological characteristics of hyperreactive malarial splenomegaly syndrome in sudanese patients.