A case of hyper-reactive malarial splenomegaly. The role of rapid antigen-detecting and PCR-based tests.

Infectious Diseases Unit, Internal Medicine Department, Hospital de la Santa Creu i Sant Pau, Universitat de Barcelona, Barcelona, Spain.
Infection (Impact Factor: 2.44). 05/2008; 36(2):167-9. DOI: 10.1007/s15010-007-6025-z
Source: PubMed

ABSTRACT 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.

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