Tropical splenomegaly syndrome, also known as hyperreactive malarial splenomegaly, occurs due immunological over-stimulation to repeated attacks of malarial infection over a long period of time.

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Clinical features

• Massive splenomegaly (> 7 cm)
  • May show features of hypersplenism (severe form):
    • Anemia
    • Thrombocytopenia
• Hepatomegaly

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Diagnosis

Investigations

Peripheral smear for malarial parasite

• Usually negative

Serology

• ↑ Serum IgM
• ↑ Anti-malarial antibodies

Histopathology

• Dilated sinusoids lined with reticulum cells
• Marked erythrophagocytosis and lymphocytic infiltration of the pulp

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Management

Antimalarial drug followed by prophylaxis for prolonged period