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Internal Medicine

Tropical splenomegaly

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.


Clinical features

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

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

Management

Antimalarial drug followed by prophylaxis for prolonged period

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