The pathogenesis of tropical splenomegaly syndrome--the role of immune complexes.

For the last few years it has been known that high molecular weight circulating immune complexes containing IgM, other immunoglobulins and complement are usually present in TSS. Similar material to be found in the Kupffer cells of affected patients, and on the surfaces of their red cells. The recent demonstration that the immune complexes contain malarial antibody activity strengthens the belief that they also contain malarial antigen and are due to the basic immunological abnormality. As indicated in this review, further studies are required fully to confirm their role in the production of the splenomegaly, the auto-immune phenomena and the haemolysis of TSS. The balance of evidence favours a genetic rather than a purely environmental basis for development of the syndrome. Treatment is simple, inexpensive and relatively free of risk. It is feasible even in rural communities pending the advent of successful malaria eradication, the ultimate means of prevention and cure.