A study on tropical splenomegaly syndrome and chloroquine prophylaxis

Forty-two adults (22 males, 20 females) with tropical splenomegaly syndrome (TSS) were studied. Majority (88.1%) presented with complaints related to grossly enlarged spleen (greater than 10 cm). The duration of splenomegaly was 1 to 5 years in 54.8%. In 80.9% there was anaemia (Hb less than 10 g%). None of the patients had a macrocytic blood picture. Evidence of portal hypertension was observed in 56.7% and almost a similar number (58.1%) had raised intrasplenic pressure. The liver histology was entirely normal in only 8.8%. T-cell lymphopenia with B-cell lymphocytosis was a prominent feature. IgM values were raised in 73.8% and malarial antibody titres in 91.7% patients. Sixty-nine per cent of cases showed a distinct clinical and biochemical improvement after chloroquine chemoprophylaxis. Though a malarial origin in the development of TSS is favoured its precise aetiology is as yet speculative.