Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In this study, 101 patients with massive splenomegaly (MS) and 41 with moderate splenomegaly (MoS) from Kassala, Eastern Sudan, were included. The patients were recruited during a peak and the end of a malaria season and during a dry season between 2007 and 2008. Based on clinical findings and exclusion of other causes of MS, the former patients were presumed to be infected with malaria parasite; thus, the condition was termed as massive malarial splenomegaly (MMS). Rapid diagnostic test (RDT) and polymerase chain reaction (PCR) were used for malaria parasite detection. In the MMS group, the parasite rate was 50% and 49% as estimated by microscopy and RDT, respectively. However, the PCR showed higher parasite rate (79.3%, P = 0.000), Plasmodium vivax infection, and mixed infections. The PCR-corrected parasite rate in the MoS and control groups was 73.2% and 3.5%, respectively. The parasite rate as estimated by microscopy was highest at the end of the malaria season and lowest in the dry season; however, the parasite rate estimated by PCR was stable in all study periods. There was significant reduction in spleen size following anti-malaria treatment. In conclusion, the use of PCR had revealed significantly higher parasite rate, P. vivax, and mixed infections in MMS as compared to microscopy, while the RDT was found to be comparable to microscopy and is suggested to complement the use of the latter. The study also disclosed a seasonal variation of patent parasitemia with an overall low parasite count and scarce gametocytaemia in MMS.
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PMID:Validation of PCR for detection and characterization of parasitaemia in massive splenomegaly attributed clinically to malaria infection. 2139 75

In tropical countries like India, malaria has been one of the most common parasitic illnesses leading to frequent hospitalization and causing major economic burden among the masses. Although Plasmodium vivax infection is considered to be benign, in contrast to Plasmodium falciparum infection which is notorious for its severe splenic complications can occur frequently. Splenomegaly tends not to receive special attention, as it is not usually accompanied by any symptoms and can be gradually resolved via standard antimalarial therapy. Splenic infarction, although rarely attributable to malaria in an endemic region with high parasitemia, can be a rare presentation of this disease entity.
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PMID:Multiple splenic infarcts in acute Plasmodium vivax malaria: a rare case report. 2360 86

A 4-year-old boy from the United States had been staying in Indonesia for five months when he presented with fever, severe lethargy, progressive weight loss, and abdominal distension. He was first diagnosed with Plasmodium vivax infection in Indonesia and received treatment with chloroquine. However, his condition continued to deteriorate and he required erythrocyte transfusion for severe anemia. Three weeks into his illness, he was found to have low parasitemia with Plasmodium falciparum with massive hepatosplenomegaly in Singapore. A splenic infarct was also documented on computed tomography. Treatment with atovaquone-proguanil resulted in stabilization of the hemoglobin level and rapid reduction in splenic size, with clearance of malarial parasites from the bloodstream. Although reported typically in adult tropical residents, hyper-reactive malarial splenomegaly may occasionally be found in the pediatric traveler. Clinicians receiving children returning from the tropical regions should be aware of this potentially life-threatening complication of partially treated malaria.
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PMID:Hyper-reactive malarial splenomegaly and splenic infarct in a caucasian toddler. 2447 Sep 10

In spite of the fact that Plasmodium vivax is the leading causative agent of malaria in our country, imported malaria cases have been reported, recently. In this report, two malaria cases originated from sub-Saharan Africa, and their diagnostic and therapeutic approaches were aimed to be presented. First case, 45-year-old male, who has been working in Republic of Ghana, was admitted to Hacettepe University Hospitals Emergency Service with complaints of fever, sweating and shivering, after returning to Turkey. On admission, his general condition was fine and his physical examination revealed no pathological finding. After his admission, a fever episode occured and his blood tests revealed anemia, trombocytopenia and increased alkaline phosphatase level. Second case, 39-year-old-male admitted to the emergency service with the complaints of fever, shivering and myalgia. His physical examination revealed decreased breath sounds and splenomegaly, his laboratory tests resulted in pansitopenia and elevated liver enzymes. In the thick blood smears of the patients ring formed young trophozoites are detected and in the thin films multiple ring forms demonstrated in one erythrocyte with the absence of mature trophozoites and schizont forms, which were compatible with falciparum malaria. The rapid antigen test (Digamed, Belgium) of the second case found to be positive for both Plasmodium falciparum and P.vivax and this patient followed-up in intensive care unit due to his deterioration of general condition, respiratory distress, hematuria and change of consciousness. Neither cases were commenced on malaria prophylaxis. Both patients have been in countries which chloroquine resistance is commonly seen, they were treated with artemether/lumefantrine as current World Health Organization recommended. Targeting hypnozoites of P.vivax, primaquine was added to the therapy of the second patient. Both patients resulted in cure. In conclusion, while travelling to endemic countries, people should be informed about the importance of malaria prophylaxis and prophylaxis should be commenced immediately and continued appropriately. Additionally, malaria should always be considered in the differential diagnosis of high fever for the patients who admitted to the hospital with a travelling history to these countries.
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PMID:[The Importance of Awareness for Malaria Regarding Prophylaxis and Early Diagnosis: Two Imported Malaria Cases in Turkey]. 3170 45