Abstract
Malaria infections in pregnancy are associated with adverse outcomes for both mother and child. There are few data on hyper-reactive malarial splenomegaly, an aberrant immunological response to chronic or recurrent malaria in pregnancy. This retrospective assessment reviewed the impact of mefloquine treatment on pregnant women with suspected hyper-reactive malarial splenomegaly in an area of low malaria transmission in the 1990s, showing significant reductions in spleen size and anemia and anti-malarial antibody titers without any notable negative effect on treated women or their newborns.
Highlights
There are few data in the literature addressing Hyper-reactive malarial splenomegaly (HMS) in pregnancy,[12,13] which is of particular relevance given the susceptibility of pregnant women to malaria, the risk of splenomegaly in pregnancy in terms of anemia, thrombocytopenia, and increased susceptibility to infection, and the anxiety related to the safe administration of anti-malarial medication to pregnant women
One hundred and twenty-nine samples were processed for total immunoglobulin M (IgM) and IgG (Minineph, The Binding Site, Birmingham, UK); anti-malarial antibody titers (ELISA, DiaMed, Switzerland) were measured in a smaller subset of 87 samples taken from 23 cases
Pre-mefloquine treatment plasma titers for cases were significantly higher than controls for all measurements (Figure 1): total IgM was 6.1 (95% confidence interval [CI] 3.8–8.5) versus 2.1 IU/mL, P = 0.001; total IgG was 17.6 versus 12.5 IU/mL, P < 0.0001; and anti-malarial antibody index values were 9.1 versus 2.6, P < 0.0001
Summary
There are few data in the literature addressing HMS in pregnancy,[12,13] which is of particular relevance given the susceptibility of pregnant women to malaria, the risk of splenomegaly in pregnancy in terms of anemia, thrombocytopenia, and increased susceptibility to infection, and the anxiety related to the safe administration of anti-malarial medication to pregnant women. This retrospective analysis aimed to characterize the effects of mefloquine treatment on spleen size and maternal IgM, IgG, and anti-malarial antibodies in preg-
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