Persistent gross splenomegaly in Nigerian patients with sickle cell anaemia: relationship to malaria

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Abstract
Serum IgM levels, hepatic histopathology, and response to prolonged proguanil treatment were investigated in 15 patients with sickle cell anaemia (SS), aged 8–15 years, with persistent gross splenomegaly (PGS). They were compared with age-and sex-matched SS patients without splenomegaly and with AA controls. The mean ± SD serum IgM levels were 249·7(75) mg/100 ml in the SS patients with PGS, 157·6(57·3) mg/100 ml in the SS patients without splenomegaly, and 146·2(48·9) mg/100 ml in the AA controls. The differences between these mean values were statistically significant (PP<0·01). This study has confirmed the previous belief that malaria plays a role in the aetiopathogenesis of persistent splenomegaly in sickle cell patients in a fashion similar to, but not quite the same as in, tropical splenomegaly syndrome (TSS). It also underscores the need for malaria chemoprophylaxis in these patients.