Serveur d'exploration sur la grippe aux Pays-Bas

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[Splenomegaly in an Eritrean refugee: the hyper-reactive malaria splenomegaly syndrome.]

Identifieur interne : 000061 ( Main/Exploration ); précédent : 000060; suivant : 000062

[Splenomegaly in an Eritrean refugee: the hyper-reactive malaria splenomegaly syndrome.]

Auteurs : M M Cruijsen [Pays-Bas] ; I J Reuling ; M. Keuter ; R W Sauerwein ; A J Van Der Ven ; Q. De Mast

Source :

RBID : pubmed:27848905

Descripteurs français

English descriptors

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.


PubMed: 27848905


Affiliations:


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Le document en format XML

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<title xml:lang="en">[Splenomegaly in an Eritrean refugee: the hyper-reactive malaria splenomegaly syndrome.]</title>
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<name sortKey="Cruijsen, M M" sort="Cruijsen, M M" uniqKey="Cruijsen M" first="M M" last="Cruijsen">M M Cruijsen</name>
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<nlm:affiliation>Radboudumc, Nijmegen.</nlm:affiliation>
<country>Pays-Bas</country>
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<settlement type="city">Nimègue</settlement>
<region type="province" nuts="2">Gueldre</region>
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<name sortKey="Reuling, I J" sort="Reuling, I J" uniqKey="Reuling I" first="I J" last="Reuling">I J Reuling</name>
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<name sortKey="Keuter, M" sort="Keuter, M" uniqKey="Keuter M" first="M" last="Keuter">M. Keuter</name>
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<name sortKey="Sauerwein, R W" sort="Sauerwein, R W" uniqKey="Sauerwein R" first="R W" last="Sauerwein">R W Sauerwein</name>
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<name sortKey="Van Der Ven, A J" sort="Van Der Ven, A J" uniqKey="Van Der Ven A" first="A J" last="Van Der Ven">A J Van Der Ven</name>
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<term>Adult (MeSH)</term>
<term>Eritrea (MeSH)</term>
<term>Hepatomegaly (MeSH)</term>
<term>Humans (MeSH)</term>
<term>Malaria (diagnosis)</term>
<term>Malaria (drug therapy)</term>
<term>Malaria (parasitology)</term>
<term>Male (MeSH)</term>
<term>Netherlands (MeSH)</term>
<term>Refugees (MeSH)</term>
<term>Splenomegaly (diagnosis)</term>
<term>Splenomegaly (drug therapy)</term>
<term>Splenomegaly (parasitology)</term>
<term>Syndrome (MeSH)</term>
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<term>Adulte (MeSH)</term>
<term>Humains (MeSH)</term>
<term>Hépatomégalie (MeSH)</term>
<term>Mâle (MeSH)</term>
<term>Paludisme (diagnostic)</term>
<term>Paludisme (parasitologie)</term>
<term>Paludisme (traitement médicamenteux)</term>
<term>Pays-Bas (MeSH)</term>
<term>Réfugiés (MeSH)</term>
<term>Splénomégalie (diagnostic)</term>
<term>Splénomégalie (parasitologie)</term>
<term>Splénomégalie (traitement médicamenteux)</term>
<term>Syndrome (MeSH)</term>
<term>Érythrée (MeSH)</term>
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<term>Malaria</term>
<term>Splenomegaly</term>
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<term>Splénomégalie</term>
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<term>Malaria</term>
<term>Splenomegaly</term>
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<term>Splénomégalie</term>
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<term>Malaria</term>
<term>Splenomegaly</term>
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<term>Splénomégalie</term>
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<term>Eritrea</term>
<term>Hepatomegaly</term>
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<term>Hépatomégalie</term>
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<term>Pays-Bas</term>
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<div type="abstract" xml:lang="en">
<p>
<b>BACKGROUND</b>
</p>
<p>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.</p>
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<p>
<b>CASE DESCRIPTION</b>
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<p>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.</p>
</div>
<div type="abstract" xml:lang="en">
<p>
<b>CONCLUSION</b>
</p>
<p>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.</p>
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<Day>07</Day>
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<Title>Nederlands tijdschrift voor geneeskunde</Title>
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<AbstractText Label="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.</AbstractText>
<AbstractText Label="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.</AbstractText>
<AbstractText Label="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.</AbstractText>
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