title: [Hyperreactive malarial splenomegaly in a European returning from Africa].
abstract: 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.
authors.affiliation: Service de médecine interne, Hôpital d'instruction des armées Clermont-Tonnerre, Brest Naval, France.
authors.forename: H
authors.initials: H
authors.lastname: Granier
authors.forename: R
authors.initials: R
authors.lastname: Vatan
authors.forename: X
authors.initials: X
authors.lastname: Nicolas
authors.forename: M
authors.initials: M
authors.lastname: Richecoeur
authors.forename: J
authors.initials: J
authors.lastname: Martin
mesh_terms: 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*
chemical_list: D000913:Antibodies, Protozoan; D007075:Immunoglobulin M
vernacular_title: Splénomégalie malarique hyperréactive chez un Européen revenant d'Afrique.