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近20年间,热带地区疟疾脾肿大的概念有了显著改变。半免疫或无免疫者的疟疾脾肿大与通常认为的热带脾肿大综合症(TSS)之间存在着本质差别。在疟疾流行区,伴有寄生虫血症和肝脾吞噬细胞疟原虫色素沉积的部分儿童具有脾肿大;随着免疫力的逐渐获得,寄生虫血症渐少见,疟疾色素不见,肿大脾回缩。无疟疾免疫力的脾肿大也可见于成人,如急性发作,非恶性疟的复发和逗留在流行区的旅游者。本文建议把上述情况命之为“非免疫性疟疾脾肿大”。
Over the past two decades, the concept of malaria splenomegaly in the tropics has changed significantly. There is an essential difference between malaria splenomegaly in semi-immunized or non-immunized individuals and what is commonly thought to be in the case of tropical splenomegaly syndrome (TSS). In malaria-endemic areas, some children with parasitemia and pigmentation of the malaria parasite phagocytes have splenomegaly; as immunity gradually gains, parasitemia is less common, malaria pigment is missing, swollen spleen Retraction. Malaria-free splenomegaly can also be seen in adults, such as acute attacks, recurrence of non-falciparum malaria and travelers staying in endemic areas. This article suggests that this be the case of “non-immune malaria splenomegaly.”