Anaemia in pregnancy associated with "big spleen disease".

We have previously reported an association between idiopathic tropical splenomegaly, lymphocytic infiltration of the hepatic sinusoids, hyperglobulinaemia, and a raised fluorescent antibody titre to malaria, and have suggested that this is due to an abnormal immune response to malaria, possibly connected with Plasmodium malariae infection (Gebbie et al., 1964; Marsden et ai., 1965). This syndrome is known locally as big spleen disease, and is referred to by that title in this paper. These patients usually have a chronic anaemia due to a shortened red-cell survival (Marsden et al., 1965). In one series 13 of the 15 females were pregnant or lactating (Gebbie et al., 1964).