Camara B, Kantambadouno J-B, Martin-Blondel G, Berry A, Alvarez M, Benoit-Vical F, Delmont J, Bouchaud O, Marchou B
Service de maladies infectieuses et tropicales, hôpital Purpan, 1, place Baylac, 31059 Toulouse, cedex 9, France.
Med Mal Infect. 2009 Jan;39(1):29-35. doi: 10.1016/j.medmal.2008.09.002. Epub 2008 Oct 25.
Hyperreactive malarial splenomegaly (HMS) is the chronic stage of a long-term stimulation of the immune system secondary to plasmodial infections, more frequently in genetically predisposed patients. HMS is a leading cause of large tropical splenomegaly in endemic zones but has been described in immigrants from Africa and in some European expatriates living in endemic countries. Diagnostic criteria include: long-term stay in a endemic zone, often large splenomegaly, high IgM titer, high antiplasmodial antibody titer, regression by at least 40% of splenomegaly six months after curative antimalarial treatment. In tropical settings, B-cell lymphoma and splenic lymphoma are the main differential diagnoses, which may be identified by a clonality analysis. Recent studies suggest that HMS can be treated by a short-term antimalarial therapy as long as the patient resides out of a malarial endemic country.
高反应性疟疾脾肿大（HMS）是疟原虫感染继发免疫系统长期刺激后的慢性阶段，在有遗传易感性的患者中更为常见。HMS是流行地区热带巨脾的主要原因，但在来自非洲的移民以及一些生活在流行国家的欧洲侨民中也有描述。诊断标准包括：长期居住在流行地区、常有巨脾、高IgM滴度、高抗疟原虫抗体滴度、根治性抗疟治疗六个月后脾肿大至少消退40%。在热带地区，B细胞淋巴瘤和脾淋巴瘤是主要的鉴别诊断，可通过克隆性分析来识别。最近的研究表明，只要患者居住在疟疾流行国家以外，HMS可通过短期抗疟治疗。
