Hyperreactive malaria in expatriates returning from sub-Saharan Africa
| Autor: | J Van den Ende, T. Vervoort, G Vanham, E Van den Enden, Henri Taelman, A Van Gompel |
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| Rok vydání: | 2000 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Plasmodium falciparum Antibodies Protozoan Spleen Antimalarials Belgium Recurrence Chloroquine Immunity Internal medicine medicine Imported diseases Animals Humans Outpatient clinic Malaria Falciparum Child Africa South of the Sahara Aged Retrospective Studies biology business.industry Public Health Environmental and Occupational Health Retrospective cohort study Syndrome Protozoal diseases Middle Aged biology.organism_classification medicine.disease Malaria Infectious Diseases medicine.anatomical_structure Immunoglobulin M Splenomegaly Immunology biology.protein Travel medicine Female Parasitology Europe West business medicine.drug |
| Zdroj: | Tropical medicine and international health |
| ISSN: | 1365-3156 1360-2276 |
| Popis: | The definitive version is available at www3.interscience.wiley.com Summary The extreme presentation of hyperreactive malaria is hyperreactive malarial splenomegaly syndrome (HMS). Some patients present with a less pronounced syndrome. To investigate whether the degree of splenomegaly correlates with the degree of immune stimulation, whether prophylaxis or recent treatment play a role, and whether short therapy alone is effective, we examined retrospectively the medical records of expatriates with exposure to P. falciparum who attended our outpatient department from 1986 to 1997, particularly subacute symptoms or signs, strongly elevated malarial antibodies and elevated total serum IgM. We analysed duration of stay, prophlyaxis intake, spleen size, serum IgM levels and response to antimalarial treatment. Serum IgM levels were significantly higher in patients with larger splenomegaly. The use of chloroquine alone as treatment for presumptive or proved malaria attacks was correlated with larger spleen size. Short adequate antimalarial therapy resulted in marked improvement or complete recovery. In nine patients the hyperreactive response reappeared after re-exposure, in four of them twice. We conclude that patients with subacute symptoms but without gross splenomegaly may have very high levels of IgM and malarial antibodies, and relapse on re-exposure, suggesting the existence of a variant of the hyperreactive malarial splenomegaly syndrome without gross splenomegaly. |
| Databáze: | OpenAIRE |
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