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Dr. Ananda Prasad: Comment #2

Comment #2

In this paper we described a new syndrome of hypogammaglobulinemia, splenomegaly and hyperplenism (Prasad syndrome).  Our patients had repeated severe infections such as pneumonia, meningitis and other bacterial infections because of decreased production of gamma globulins.  On examination of the bone marrow, we observed that there was a lack of plasma cells accounting for hypogammaglobulinemia and a secondary hyperplasia of the reticulum cells was prominent.  We hypothesized that hepatosplenomegaly and lymphadenopathy in these patients were due to reticulum cell hyperplasia.  Enlarged spleen resulted in hypersplenism and hemolytic anemia. Prior to our description of this syndrome, these patients were mistakenly diagnosed as cases of malignant lymphoma.  The patients benefited by parenteral administration of gamma globulin periodically.  The mechanism by which the bone marrow was unable to generate plasma cells in this syndrome remains unknown. 

Ref.  Prasad, A.S., Reiner, E., Watson, C.J.  Syndrome of hypogammaglobuline­mia, splenomegaly, and hypersplenism.  Blood, 12:926‑932, 1957.