Concurrent hyperreactive malarial splenomegaly and quartan malarial nephropathy - Plasmodium malariae revisited.

Chronic immunological complications of malaria include hyperreactive malarial splenomegaly (HMS) and quartan malarial nephropathy. HMS represents an abnormal immunological response to recurrent malarial infections as a result of defective T suppressor cell regulation. On the other hand, quartan malarial nephropathy, which usually presents in childhood with nephrotic syndrome, is not responsive to antimalarial therapy, and thus may progress to end-stage renal failure. We presented a patient with HMS, who developed recrudescence of malaria, and quartan nephropathy after splenectomy.