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Volume 310:337-341 February 9, 1984 Number 6 Next

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Abstract

To study the pathogenesis of tropical splenomegaly syndrome, we compared immunologic findings in patients from Flores, Indonesia, with those obtained in local residents without splenomegaly and in controls. Villagers with tropical splenomegaly syndrome had markedly elevated levels of total IgM, higher titers of IgM antibodies to Plasmodium vivax, and reduced levels of circulating T lymphocytes. The latter were caused by a decrease in the total number of T cells with the suppressor/cytotoxic phenotype (T8+). Levels of B lymphocytes were similar in all groups. All immunologic abnormalities reverted toward normal in patients treated weekly for 9 to 26 months with chloroquine phosphate. These findings suggest that overproduction of immunoglobulins in patients with tropical splenomegaly syndrome is caused by an imbalance in the normal ratio of helper: suppressor T cells that regulate B-lymphocyte function, and that this imbalance is due to a decrease in suppressor T lymphocytes.

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• De Franceschi, L., Sada, S., Andreoli, A., Angheben, A., Marocco, S., Bisoffi, Z. (2005). Sickle cell disease and hyperreactive malarial splenomegaly (HMS) in young immigrants from Africa. Blood 106: 4415-4417 [Full Text]  
• Wyler, D. J., Mattia, A. R. (1994). Case 11-1994- A 35-Year-Old Ethiopian Man with Splenomegaly and Recurrent Fever. NEJM 330: 775-781 [Full Text]