Chagas’ heart disease

Bystander activation activation of autoreactive cells through nonspecific inflammation and induction of inflammatory cytokines and chemokines is also of pathological consequence in MS. It has been suggested that bystander activation, induced by persistent virus infection or primed by molecular mimicry may activate autoreactive T-cells specific for the CNS (McCoy et al., 2006). Einally, cryptic antigens may also play a role in immune activation. In other immune-mediated diseases such as Chronic Lymphocytic Thyroiditis and Chagas Heart Disease, exposure of cryptic epitopes leads to the activation of autoimmune cells and further contributes to... 

Leon IS, Engman DM (2003) The significance of autoimmunity in the pathogenesis of Chagas heart disease. Front Biosci 8 e315— e322. 

Rassi A Jr, Rassi A, Little WC. Chagas heart disease. Clin Cardiol 2000 23 883-889. 

Conduction disturbances are frequently found in acute and chronic Chagas disease. In cultures of neonatal rat hearts, changes in the gap junction distribution were studied to discover whether they were associated with the infection. In cultured cardiomyocytes infected with the unicellular parasite Trypanosoma cruzi responsible for Chagas disease, which is the most common cause of heart disease in South America, reduced gap junctional conductance... 

Lauria-Pires L, Braga MS, Vexenat AC, et al. Progressive chronic Chagas s heart disease after treatment with anti-Typanosoma cruzi ni-troderivatives. Am J Trop Med Hyg 2000 63 111-118. 

The drugs used for T. cruzi include nifurtimox (Lampit) and benznidazole (Rochagan). Oral nifurtimox is available from the CDC, while benznidazole is only available in Brazil. The adult dose of nifurtimox is 8 to 10 mg/kg per day in divided doses for 120 days. Since children seem to tolerate the dose better than adults, the pediatric dose of nifurtimox in children 1 to 10 years old is 15 to 20 mg/kg per day, and the dose for children 11 to 16 years old is 12.5 to 15 mg/kg per day in divided doses. Symptomatic treatment for heart failure associated with Chagas disease should be initiated. The gastrointestinal complications may require surgical revisions and reconstruction. 

Treatment of the acute phase of the disease (i.e., fever, malaise, edema of the face, and hepatosplenomegaly) is nifurtimox. The congestive heart failure associated with cardiomyopathy of Chagas disease is treated the same way as cardiomyopathy from other causes. 

Chagas disease prevalent in South and Central America, affecting 16-18 million people in 21 countries. Causes 13,000 deaths per year. Infection is often asymptomatic for years but can eventually cause fatal heart damage. Two drugs are available for treatment, but can have serious and frequent side-effects. Dengue fever more than one-third of the world s population are under threat from this mosquito-borne disease. Responsible tor 21,000 deaths per year. No specific treatment exists. 

Trypanosomiasis [Chagas disease African sleeping sickness] Heart brain many other organs Early stages pentamidine, suramin Later stages melarsoprol Nifurtimox... 

Moffa PJ, Del Nero E, Tobias NM, et al. The left anterior septal block in Chagas disease. Jap Heart J 1982 23 163-165. 

In chronic trypanosomiasis (Chagas disease), patients present with cardiomyopathy and heart failure. 

Viotti R, Vigliano C, Armenti H et al. Treatment of chronic Chagas disease with benznidazole Clinical and serological evolution of patients with long-term follow-up. Am Heart J 1994 127 151-62. 

Cases of Chagas disease (a parasitic disease that can lead to heart and intestinal complications) have been... 

In America, from Mexico down to the Argentine, a different species T. cruzi) is transmitted by a face-biting nocturnal bug. The result, Chagas disease, is caused by trypanosomes lodging in the heart muscle, leading often to sudden heart failure, especially in children. About 12 million cases a year occur. For some effective drugs, see Section 6.3.3. Chagas disease is confined to underdeveloped areas, and is intensified by under-nutrition. 

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