The Immunological Characterization of Hyper-reactive Malarial Splenomegaly Syndrome (HMS) in Sudan

Abstract

The present work aied at studying the immunological characterization of Hyper-reactive Malarial Splenomegaly Syndrome in Sudan. A hospital based study was carried out in the period between January 2000 and December 2004 in Ommdurman Tropical Diseases Hospital. HMS patients were interviewed and they had many investigations to differentiate HMS from other diseases which cause splenomegaly. Thirty one samples were collected to determine the molecular characterizations of the malaria parasite and to determine immunological responses to malaria candidate Circumsporozoite protein (CSP), also to measure the level of total IgM in Sudanese HMS patients' sera and to measure their cytokines (IL-10 & IFNγ). Males were found more affected by the disease (61%male - 38%female). The most common age group affected was between eleven and thirty two. Microscopic detection has shown that only one HMS patient had positive blood film for P. falciparum. No other malaria parasite species were detected. Using PCR the result was in agreement with the microscopic examinations P. falciparum parasite was detected in one patient, and no infection with P. vivax was detected. IgG antibodies to malaria specific antigen (CSP) were measured in 31 sera samples, IgG titers were found to be high but not significant in HMS patients compared with positive malaria control, whereas positive malaria controls showed significantly higher titers compared with European negative malaria control (P=0.005).