Pathology of patients with Chagas' disease and acquired immunodeficiency syndrome

Pathology of patients with Chagas' disease and acquired immunodeficiency syndrome

Author Rocha, Ademir Google Scholar
Meneses, Antonio Carlos Oliveira de Google Scholar
Silva, Arnaldo Moreira da Google Scholar
Ferreira, Marcelo Simão Google Scholar
Nishioka, Sergio Andrade Google Scholar
Burgarelli, Marcius K. N. Google Scholar
Almeida, Eros Google Scholar
Turcato Junior, Gilberto Autor UNIFESP Google Scholar
Metze, Konradin Google Scholar
Lopes, Edison Reis Google Scholar
Institution FAC MED TRIANGULO MINEIRO
Universidade Federal de Uberlândia (UFU)
Universidade Estadual de Campinas (UNICAMP)
Universidade Federal de São Paulo (UNIFESP)
Abstract The main pathologic findings in 23 patients with acquired immunodeficiency syndrome (AIDS) and Chagas' disease are reviewed; five are from our own experience and 18 from the literature. The presence of Trypanosoma cruzi parasites and/or T. cruzi antibodies in blood and cerebrospinal fluid was recorded and computerized tomograms of the brain were evaluated. Twenty (87%) of the 23 subjects developed severe, multifocal or diffuse meningoencephalitis with necrosis and hemorrhage associated with numerous tissue parasites. The second most severely affected site was the heart. Seven (30.4%) of the 23 cases had myocarditis on pathologic examination. It was acute in four patients, chronic in two, and simultaneously acute and chronic in one. Acute myocarditis and me ningoencephalitis are interpreted as being caused by relapses of chronic T. cruzi infections. An AIDS permissive role is suggested for these conditions since immunologic defense against T. cruzi is mediated mainly by T lymphocytes, whose CD4 subpopulation is depleted in patients with this disease. Consequently, AIDS is a factor that may favor the reactivation of T. cruzi infections. The lesions reported in the association of Chagas' disease with AIDS were compared with those reported from patients without AIDS having fatal, acute, vector-transmitted infections, contaminated blood transfusions, or accidental exposures in the laboratory. For the latter three, meningoencephalitis is uncommon. Only immunosuppressed cases of Chagas' disease have been described as having a pseudotumoral presentation that shows expanding lesions with a mass effect in the cranial cavity that causes intracranial hypertension and simulates neoplasms (tumors such as gliomas, lymphomas, metastases, etc.).
Language English
Date 1994-03-01
Published in American Journal Of Tropical Medicine And Hygiene. Mclean: Amer Soc Trop Med & Hygiene, v. 50, n. 3, p. 261-268, 1994.
ISSN 0002-9637 (Sherpa/Romeo, impact factor)
Publisher Amer Soc Trop Med & Hygiene
Extent 261-268
Origin https://doi.org/10.4269/ajtmh.1994.50.261
Access rights Closed access
Type Article
Web of Science ID WOS:A1994NE91800001
URI http://repositorio.unifesp.br/11600/42471

Show full item record




File

File Size Format View

There are no files associated with this item.

This item appears in the following Collection(s)

Search


Browse

Statistics

My Account