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Case Report: Hyperreactive Malarial Splenomegaly Syndrome Diagnosed with Loop-Mediated Isothermal Amplification and Treated with Artemisinin-Based Combination Therapy

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  • 1 Infectious Diseases Department, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Brussels, Belgium;
  • | 2 Infectious Diseases, Department of Mental and Physical Health and Preventive Medicine, Università della Campania “Luigi Vanvitelli,” Naples, Italy;
  • | 3 Hematology Department, Laboratoire Hospitalier Universitaire de Bruxelles - Université Libre de Bruxelles, CHU Saint-Pierre, Brussels, Belgium
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Hyperreactive malarial splenomegaly syndrome (HMSS) is a rare cause of splenomegaly in the Western world. Hyperreactive malarial splenomegaly syndrome is caused by an aberrant immunological response to chronic malaria exposure in endemic areas. Revised Fakunle’s criteria may be helpful for diagnosis: persistent splenomegaly (> 10 cm below the costal margin), increased anti-Plasmodium antibodies, increased IgM levels, exclusion of other causes of splenomegaly or malignancy, and a favorable response to antimalarial treatment. We describe the case of a 16-year-old patient, who recently arrived in Belgium from Guinea with a history of splenomegaly and B symptoms in whom HMSS diagnosis was achieved, thanks to the loop-mediated isothermal amplification method. To our knowledge, this is also the first described case treated by dihydroartemisinin/piperaquine.

Author Notes

Address correspondence to Charlotte Martin, Infectious Diseases Department, CHU Saint-Pierre, Brussels, Belgium. E-mail: charlotte_martin@stpierre-bru.be

Authors’ addresses: Francesco G. Genderini, Infectious Diseases Department, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Brussels, Belgium, and Infectious Diseases, Department of Mental and Physical Health and Preventive Medicine, Università della Campania “Luigi Vanvitelli,” Naples, Italy, E-mail: francesco_genderini@stpierre-bru.be. Cecile Haeseleer and Brigitte Cantinieaux, Hematology Department, LHUB-ULB, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Brussels, Belgium, E-mails: cecile.haeseleer@lhub-ulb.be and brigitte.cantinieaux@lhub-ulb.be. Charlotte Martin, Infectious Diseases Department, Centre Hospitalier Universitaire (CHU) Saint-Pierre, Brussels, Belgium, E-mail: charlotte_martin@stpierre-bru.be.

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