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Ultrasonographic assessment of splenic volume at presentation and after anti-malarial therapy in children with malarial anaemia.

Moses Laman, Susan Aipit, Cathy Bona, Peter M Siba, Leanne J Robinson, Laurens Manning, Timothy M E Davis
School of Medicine and Pharmacology, University of Western Australia, Fremantle Hospital, PO Box 480, Fremantle, 6959, WA, Australia. [email protected]


BACKGROUND: Splenic enlargement is a component of the host response to malaria and may also influence the genesis and progression of malarial anaemia. Few cross-sectional and no longitudinal studies have assessed the relationship between splenic volume measured ultrasonographically and haemoglobin concentrations in children with malaria. METHODS: Fifteen Papua New Guinean children with severe malarial anaemia (SMA; haemoglobin/=0.90). Mean splenic volume had fallen by approximately 50% at day 14 in children with MMA (P</=0.011 vs days 0, 1 and 2), but there was no change in the SMA group (P>/=0.30). There was no change in haemoglobin in the MMA group during follow-up but a rise in the SMA group to day 7 (P</=0.05 vs days 0, 1, 2, and 3) which paralleled the packed cell volume transfused. CONCLUSIONS: Clinical assessment of splenomegaly is imprecise compared with ultrasonography. Serial splenic volumes and haemoglobin concentrations suggest that the spleen does not influence post-treatment haemoglobin, including after transfusion.


  • Journal: Malaria Journal
  • Published: 28/05/2015
  • Volume: 14
  • Pagination: 219


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