Nederlands Tijdschrift voor Geneeskunde
Volume 160, Issue 50, 2016

Splenomegaly in an Eritrean refugee: The hyper-reactive malaria splenomegaly syndrome [Splenomegalie bij een Eritrese vluchteling: HET HYPERREACTIEF-MALARIA-SPLENOMEGALIESYNDROOM] (Article)

Cruijsen M.M. , Reuling I.J. , Keuter M. , Sauerwein R.W. , Van Der Ven A.J. , De Mast Q.*
  • a Radboudumc, Nijmegen, Netherlands
  • b Radboudumc, Nijmegen, Netherlands
  • c Radboudumc, Nijmegen, Netherlands
  • d Radboudumc, Nijmegen, Netherlands
  • e Radboudumc, Nijmegen, Netherlands
  • f Radboudumc, Nijmegen, Netherlands

Abstract

Background Hyper-reactive malaria splenomegaly (HMS) is a rare and potentially severe complication of malaria. It is likely that the incidence of patients with HMS will rise in the Netherlands due to the recent increase in asylum-seekers from Sub-Saharan Africa. It can be difficult to diagnose this disease, as this case shows. Case description A 31-year-old male from Eritrea was admitted with fever and dyspnea, caused by an influenza A-infection. The patient also presented with cachexia, pronounced hepatosplenomegaly and pancytopenia. Microscopic diagnostic analysis for malaria was negative. HMS was eventually diagnosed through high-sensitivity qPCR for malaria, which showed the presence of a very low level of Plasmodium falciparum parasitemia; furthermore, IgM levels were high and malaria serology was strongly positive. Conclusion HMS should be considered in patients from malaria-endemic areas presenting with splenomegaly and pancytopenia. Because standard diagnostics for malaria are often negative in this population, malaria serology and sensitive qPCR play an important diagnostic role.

Author Keywords

[No Keywords available]

Index Keywords

Netherlands parasitology Eritrea refugee cachexia hepatosplenomegaly human hepatomegaly Refugees splenomegaly Malaria Pancytopenia hyperreactive malaria splenomegaly Humans syndrome male case report diagnostic test Article Eritrean adult fever serology malaria falciparum dyspnea
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85006300298&partnerID=40&md5=4dfe4760b5cfa35728099b5e081ea1d6
ISSN: 00282162
Original Language: Dutch