Polymorphic Sites at the Immunoregulatory CTLA-4 Gene Are Associated with Chronic Chagas Disease and Its Clinical Manifestations

We conducted a clinical and electromyographical study in patients with Chagas' disease in the indeterminate or chronic stages of the illness. Altogether 841 patients were examined. Only 511 were admitted within the protocol; the remainder patients were rejected because they showed other causes able to damage the nervous system. Fifty two (10.17%) out of the 511 patients showed signs and symptoms of peripheral nervous system involvement in the form of sensory impairment and diminished tendon jerks suggesting the presence of neuropathy. Forty five of them were submitted to a conventional electromyographical examination. Fifteen of mem showed normal results, while the remainder 30 disclosed a reduced interference pattern, being most of the remaining motor unit potentials fragmented or poliphasic, reduced sensory and motor conduction velocities and diminished amplitude of the sensory action potential. The findings suggest that some chagasic patients in the indeterminate or chronic stages of the disease may develop a clinical mild sensory-motor peripheral neuropathy.

Download Full-text

International meeting: new diagnostic tests are urgently needed to treat patients with Chagas disease

Revista da Sociedade Brasileira de Medicina Tropical ◽

10.1590/s0037-86822008000300020 ◽

2008 ◽

Vol 41 (3) ◽

pp. 315-319 ◽

Cited By ~ 29

Keyword(s):

Chagas Disease ◽

Diagnostic Tests ◽

Clinical Manifestations ◽

Specific Treatment ◽

Treatment Access ◽

Limited Effectiveness ◽

Technical Report ◽

Blood Banks ◽

Chronic Chagas Disease ◽

Cruzi Infection

Trypanosoma cruzi infection is often not detected early on or actively diagnosed, partly because most infected individuals are either asymptomatic or oligosymptomatic. Moreover, in most places, neither blood banks nor healthcare units offer diagnostic confirmation or treatment access. By the time patients present clinical manifestations of advanced chronic Chagas disease, specific treatment with current drugs usually has limited effectiveness. Better-quality serological assays are urgently needed, especially rapid diagnostic tests for diagnosis patients in both acute and chronic phases, as well as for confirming that a parasitological cure has been achieved. Some new antigen combinations look promising and it is important to assess which ones are potentially the best, together with their requirements in terms of investigation and development. In August 2007, a group of specialized researchers and healthcare professionals met to discuss the state of Chagas infection diagnosis and to build a consensus for a plan of action to develop efficient, affordable, accessible and easy-to-use diagnostic tests for Chagas disease. This technical report presents the conclusions from that meeting.

Download Full-text

Faculty Opinions recommendation of Drug-induced cure drives conversion to a stable and protective CD8+ T central memory response in chronic Chagas disease.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1107065.576411 ◽

2008 ◽

Author(s):

Thomas W von Geldern

Keyword(s):

Chagas Disease ◽

Central Memory ◽

Drug Induced ◽

Memory Response ◽

Chronic Chagas Disease

Download Full-text

Effects of repetitive stress during the acute phase ofTrypanosoma cruziinfection on chronic Chagas' disease in rats

Stress ◽

10.1080/10253890802168648 ◽

2009 ◽

Vol 12 (2) ◽

pp. 144-151 ◽

Cited By ~ 1

Author(s):

Leony Cristina Caetano ◽

Vânia Brazão ◽

Marina Del Vecchio Filipin ◽

Fabricia Helena Santello ◽

Luana Naiara Caetano ◽

...

Keyword(s):

Chagas Disease ◽

Acute Phase ◽

Repetitive Stress ◽

Chronic Chagas Disease

Download Full-text

A systematic review of historical and current trends in Chagas disease

Therapeutic Advances in Infectious Disease ◽

10.1177/20499361211033715 ◽

2021 ◽

Vol 8 ◽

pp. 204993612110337

Author(s):

Diego-Abelardo Álvarez-Hernández ◽

Rodolfo García-Rodríguez-Arana ◽

Alejandro Ortiz-Hernández ◽

Mariana Álvarez-Sánchez ◽

Meng Wu ◽

...

Keyword(s):

Systematic Review ◽

Chagas Disease ◽

Case Reports ◽

Clinical Manifestations ◽

Human Case ◽

Acute Stage ◽

Diagnostic Tools ◽

Chronic Stage ◽

Pubmed Database ◽

Trypanocidal Drugs

Introduction: Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide. Materials and methods: We performed a systematic review following the PRISMA guidance. PubMed database was explored using the terms ‘American trypanosomiasis’ or ‘Chagas disease’. Results were limited to human case reports written in English or Spanish. A total of 258 reports (322 patients) were included in the analysis. Metadata was obtained from each article. Following this, it was analyzed to obtain descriptive measures. Results: From the sample, 56.2% were males and 43.8% were females. Most cases were from endemic countries (85.4%). The most common clinical manifestations were fever during the acute stage (70.0%), dyspnea during the chronic stage in its cardiac form (53.7%), and constipation during the chronic stage in its digestive form (73.7%). Most patients were diagnosed in the chronic stage (72.0%). Treatment was administered in 56.2% of cases. The mortality rate for the acute stage cases was 24.4%, while for the chronic stage this was 28.4%. Discussion: CD is a parasitic disease endemic to Latin America, with increasing importance due to human and vector migration. In this review, we report reasons for delays in diagnosis and treatment, and trends in medical practices. Community awareness must be increased to improve CD’s diagnoses; health professionals should be appropriately trained to detect and treat infected individuals. Furthermore, public health policies are needed to increase the availability of screening and diagnostic tools, trypanocidal drugs, and, eventually, vaccines.

Download Full-text

Ficolin‐3 in chronic Chagas disease: Low serum levels associated with the risk of cardiac insufficiency

Parasite Immunology ◽

10.1111/pim.12829 ◽

2021 ◽

Author(s):

Kárita Cláudia Freitas Lidani ◽

Fabiana Antunes Andrade ◽

Marcia Holsbach Beltrame ◽

Indira Chakravarti ◽

Maria Regina Tizzot ◽

...

Keyword(s):

Chagas Disease ◽

Serum Levels ◽

Cardiac Insufficiency ◽

Chronic Chagas Disease ◽

Low Serum

Download Full-text

Serological Diagnosis of Chronic Chagas Disease: Is It Time for a Change?

Journal of Clinical Microbiology ◽

10.1128/jcm.00142-16 ◽

2016 ◽

Vol 54 (6) ◽

pp. 1566-1572 ◽

Cited By ~ 32

Author(s):

Alba Abras ◽

Montserrat Gállego ◽

Teresa Llovet ◽

Silvia Tebar ◽

Mercedes Herrero ◽

...

Keyword(s):

Chagas Disease ◽

False Positive ◽

Disease Diagnosis ◽

Cross Reactivity ◽

Human Migration ◽

Serological Diagnosis ◽

Content Type ◽

New Generation ◽

Single Technique ◽

Chronic Chagas Disease

Chagas disease has spread to areas that are nonendemic for the disease with human migration. Since no single reference standard test is available, serological diagnosis of chronic Chagas disease requires at least two tests. New-generation techniques have significantly improved the accuracy of Chagas disease diagnosis by the use of a large mixture of recombinant antigens with different detection systems, such as chemiluminescence. The aim of the present study was to assess the overall accuracy of a new-generation kit, the Architect Chagas (cutoff, ≥1 sample relative light units/cutoff value [S/CO]), as a single technique for the diagnosis of chronic Chagas disease. The Architect Chagas showed a sensitivity of 100% (95% confidence interval [CI], 99.5 to 100%) and a specificity of 97.6% (95% CI, 95.2 to 99.9%). Five out of six false-positive serum samples were a consequence of cross-reactivity withLeishmaniaspp., and all of them achieved results of <5 S/CO. We propose the Architect Chagas as a single technique for screening in blood banks and for routine diagnosis in clinical laboratories. Only gray-zone and positive sera with a result of ≤6 S/CO would need to be confirmed by a second serological assay, thus avoiding false-positive sera and the problem of cross-reactivity withLeishmaniaspecies. The application of this proposal would result in important savings in the cost of Chagas disease diagnosis and therefore in the management and control of the disease.

Download Full-text