Maria Imaculada Muniz-Junqueira; Mário A. P. Moraes; Philip Davis Marsden
ABSTRACT
We report the clinical picture, treatment and evolution of a child with hyperreactive malarious splenomegaly treated outside the endemic area of malaria. The patient presented gross splenomegaly, proceeded from an area where malaria is endemic, showed increased immunoglobulins levels, high antimalarial antibody titres and hepatic sinusoidal lymphocytosis. The child did not return to an area where malaria is endemic and showed a favorable response to only one course of quinine. The response of this patient to limited antimalarial therapy suggests the importance of reinfection with malaria in the development and maintenance of this syndrome.
Keywords: Hyperreactive malarious splenomegaly (HMS). Chronic malaria. Short antimalarial therapy.
RESUMO
Relatamos o caso clínico, tratamento e evolução de uma criança com a síndrome da esplenomegalia hiperreativa da malária tratada fora da área endêmica para a malária. A criança apresentava importante esplenomegalia, era procedente de área endêmica para malária, os níveis de imunoglobulinas e de anticorpos antimaláricos estavam elevados e observou-se linfocitose sinusoidal hepática. A criança não voltaria mais para a área endêmica de malária, pelo que foi tratada com apenas um curso de quinino apresentando resposta clínica favorável. Esta resposta a um único curso de terapia curativa antimalárica sugere a importância da reinfecção com o parasitada malária no desenvolvimento e na manutenção desta síndrome.
Palavras-chave: Esplenomegalia hiperreativa da malária. Malária crônica. Tratamento curativo antimalárico.
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Adress to correspondence:
Dra. Maria Imaculada Muniz- Junqueira
Depto de Pediatria
Faculdade de Ciências da Saúde/UnB
70910-900
Brasilia, DF, Brasil.
Recebido para publicação em 09/04/92.
Departamento de Pediatria, de Patologia e de Clínica Médica, da Faculdade de Ciências da Saúde da Universidade de Brasília, Brasília, DF, Brasil.
