A case of hyper-reactive malarial splenomegaly. The role of rapid antigen-detecting and PCR-based tests.
Hyper-reactive malarial splenomegaly (HMS) - originally referred to as tropical splenomegaly syndrome - is characterized by a massive splenomegaly, high titres of anti-malarial antibodies and polyclonal IgM hypergammaglobulinemia. It is believed to be a consequence of an aberrant immunological response to prolonged exposure to malarial parasites. Although it is a frequent disease in the tropics, it is infrequent in western countries and is only seen in long-term residents from endemic areas. We describe the case of a 67-year-old Spanish man, a missionary in Cameroon for 30 years, who presented with a clinical history that fulfilled the diagnosis of HMS. We discuss the role and importance of PCR-based techniques in demonstrating lowgrade malarial parasitemia and the usefulness of new rapid antigen-detecting dipstick tests.
Mothe
B
B
Infectious Diseases Unit, Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat de Barcelona, Barcelona, Spain.
Lopez-Contreras
J
J
Torres
O H
OH
Muñoz
C
C
Domingo
P
P
Gurgui
M
M
D000368:Aged; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D000953:Antigens, Protozoan / Q000032:analysis*; D000962:Antimalarials / Q000627:therapeutic use; D002738:Chloroquine / Q000627:therapeutic use; D006801:Humans; D016778:Malaria, Falciparum / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D010963:Plasmodium falciparum / Q000276:immunology / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000379:methods*; D013163:Splenomegaly / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology; D014057:Tomography, X-Ray Computed
D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan; D000962:Antimalarials; D002738:Chloroquine