Volume 85, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



Among a cohort of 1,213 cases treated for malaria from an isolated Papua New Guinean population, seven adults with severe and sustained hemolytic anemia after clearance of the peripheral parasitemia were prospectively investigated. All the patients fulfilled the criteria for hyper-reactive malarial splenomegaly and in 2 of 7 cases an IgG warm antibody was identified. Hereditary hemolytic anemia was excluded in 5 of 5 patients. All treated cases improved after an initial high dose of prednisone and antimalarial chemoprophylaxis. The persistence of marked anemia in a patient with splenomegaly after a attack should raise the suspicion of hyper-reactive malarial splenomegaly.


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  1. Bassat Q, Alonso PL, , 2011. Defying malaria: fathoming severe Plasmodium vivax disease. Nat Med 1: 4849.[Crossref] [Google Scholar]
  2. Sina B, , 2002. Focus in Plasmodium vivax . Trends Parasitol 18: 287289.[Crossref] [Google Scholar]
  3. Bates I, Bedu-Addo G, , 1997. Review of diagnostic criteria of hyper-reactive malarial splenomegaly. Lancet 349: 1178.[Crossref] [Google Scholar]
  4. Crane GC, , 1992. The anaemia of hyperreactive malarious splenomegaly. Rev Soc Bras Med Trop 25: 14.[Crossref] [Google Scholar]
  5. Van den Ende J, van Gompel A, van den Enden E, Taelman H, Vanham G, Vervoort T, , 2000. Hyperreactive malaria in expatriates returning from sub-Saharan Africa. Trop Med Int Health 5: 607611.[Crossref] [Google Scholar]
  6. Cook GC, Cook GC, , 1980. The tropical splenomegaly syndrome and other splenic diseases in the tropics. , ed. Tropical Gastroenterology. Oxford: University Press, 205. [Google Scholar]
  7. Lechner K, Jäger U, , 2010. How I treat autoimmune hemolytic anemias in adults. Blood 116: 18311838.[Crossref] [Google Scholar]
  8. Bates I, Bedu-Addo G, , 1997. Chronic malaria and splenic lymphoma: clues to understanding lymphoma evolution. Leukemia 11: 21622167.[Crossref] [Google Scholar]
  9. Pouvelle B, Buffet PA, Lépolard C, Scherf A, Gysin J, , 2000. Cytoadhesion of Plasmodium falciparum ring-stage-infected erythrocytes. Nat Med 6: 12641268.[Crossref] [Google Scholar]
  10. Layez C, Nogueira P, Combes V, Costa FT, Juhan-Vague I, da Silva LH, Gysin J, , 2005. Plasmodium falciparum rhoptry protein RSP2 triggers destruction of the erythroid lineage. Blood 106: 36323638.[Crossref] [Google Scholar]
  11. Crane G, Wells J, Hudson P, , 1972. Tropical splenomegaly in New Guinea: natural history. Trans R Soc Trop Med Hyg 66: 724732.[Crossref] [Google Scholar]
  12. Bidegain F, Berry A, Alvarez M, Verhille O, Huguet F, Brousset P, Pris J, Marchou B, Magnaval JF, , 2005. Acute Plasmodium falciparum malaria following splenectomy for suspected lymphoma in 2 patients. Clin Infect Dis 40: e97e100.[Crossref] [Google Scholar]
  13. Bachmann A, Esser C, Petter M, Predehl S, von Kalckreuth V, Schmiedel S, Bruchhaus I, Tannich E, , 2009. Absence of erythrocyte sequestration and lack of multicopy gene family expression in Plasmodium falciparum from a splenectomized malaria patient. PLoS ONE 4: e7459.[Crossref] [Google Scholar]
  14. De Franceschi L, Sada S, Andreoli A, Angheben A, Marocco S, Bisoffi Z, , 2005. Sickle cell disease and hyperreactive malarial splenomegaly (HMS) in young immigrants from Africa. Blood 106: 44154417.[Crossref] [Google Scholar]
  15. Puente S, Rubio JM, Subirats M, Lago M, Gonzalez-Lahoz J, Benito A, , 2000. The use of PCR in the diagnosis of hyper-reactive malarial splenomegaly (HMS). Ann Trop Med Parasitol 94: 559563.[Crossref] [Google Scholar]
  16. Mothe B, Lopez-Contreras J, Torres OH, Muñoz C, Domingo P, Gurgui M, , 2008. A case of hyper-reactive malarial splenomegaly: the role of rapid antigen-detecting and PCR-based tests. Infection 36: 167169.[Crossref] [Google Scholar]
  17. Torres JR, Villegas L, Perez H, Suarez L, Torres MA, Campos M, , 2003. Low-grade parasitemias and cold agglutinins in patients with hyper-reactive malarious splenomegaly and acute hemolysis. Ann Trop Med Parasitol 97: 125130.[Crossref] [Google Scholar]

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  • Received : 12 Mar 2011
  • Accepted : 24 Jun 2011
  • Published online : 01 Oct 2011

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