Fatal relapse of hyperreactive malarial splenomegaly (HMS) in a 10-year old Nigerian female--a case report.

BACKGROUND

The Hyperreactive Malarial Splenomegaly Syndrome (HMS) originally called the tropical splenomegaly syndrome (TSS) or Big spleen disease refers to cases of splenomegaly in the tropics for which no cause was found despite thorough investigation. It is restricted to the malarial belt, yet there are few reports on HMS in Nigeria, probably due to a low index of suspicion and non-availability of laboratory facilities to determine titres of malarial antibodies. The objective of this paper is to highlight the features, management, risk of relapse and prognosis of HMS.

METHOD/RESULT: We present a 10-year old female with recurrent massive splenomegaly with previous clinical response to antimalarials and evidence of hypersplenism.

CONCLUSION

HMS should be suspected in any child with moderate to massive splenomegaly with evidence of hypersplenism and clinical response to antimalarials.