[Hyperreactive malarial splenomegaly in a European returning from Africa].
BACKGROUND
Hyper-reactive malarial splenomegaly (HMS) syndrome related to abnormal immunologic response to repeated malarial infections is unusual in European expatriates.


METHODS
We report the case of a 72-year-old white male patient who had been residing in the Congo and developed a typical clinical features of hyperactive malarial syndrome characterized by massive splenomegaly with hypersplenism, high titers of malarial IgM antibodies, IgM macroglobulinemia, liver and medullary lymphocytic proliferation, and a clinical and immunological response to long-term chloroquine therapy.


CONCLUSIONS
Criteria for the diagnosis of hyper-reactive malarial splenomegaly are useful. However, making a distinction from malignant lymphoproliferative disorders is difficult, as a sustained response to chloroquine is required. Therefore, chloroquine appears to have a regulatory effect on the immune system.
Granier
H
H
Service de médecine interne, Hôpital d'instruction des armées Clermont-Tonnerre, Brest Naval, France.
Vatan
R
R
Nicolas
X
X
Richecoeur
M
M
Martin
J
J
D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood; D003223:Congo; D005602:France / Q000208:ethnology; D006801:Humans; D006942:Hypergammaglobulinemia / Q000097:blood / Q000276:immunology / Q000469:parasitology; D007075:Immunoglobulin M / Q000097:blood; D008099:Liver / Q000276:immunology; D008213:Lymphocyte Activation; D008288:Malaria / Q000150:complications* / Q000276:immunology; D008297:Male; D013154:Spleen / Q000276:immunology / Q000473:pathology; D013163:Splenomegaly / Q000276:immunology / Q000469:parasitology*
D000913:Antibodies, Protozoan; D007075:Immunoglobulin M
Splénomégalie malarique hyperréactive chez un Européen revenant d'Afrique.