Association of uterine leiomyoma and Chagas' disease.

Murta, Eddie Fernando Cândido; Oliveira, Gustavo Paludetto; Prado, Fernando De Oliveira; Souza, Maria Azniv Hazarabedian de; Murta, Beatriz Martins Tavares; Adad, Sheila Jorge

doi:10.4269/ajtmh.2002.66.321

Cited by 18 publications

(9 citation statements)

References 19 publications

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“…A higher prevalence of esophageal carcinoma and uterine cervix leiomyoma has been reported in patients with chronic Chagas disease than in individuals without T. cruzi infection [55]. Esophageal carcinoma is more common in patients with Chagas disease and megaesophagus than in those without Chagas disease [56], but a similar prevalence has been reported in patients without megaesophagus, regardless of whether or not they have Chagas disease [56].…”

Section: Resultsmentioning

confidence: 90%

Immunosuppression and Chagas Disease: A Management Challenge

et al. 2013

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Immunosuppression, which has become an increasingly relevant clinical condition in the last 50 years, modifies the natural history of Trypanosoma cruzi infection in most patients with Chagas disease. The main goal in this setting is to prevent the consequences of reactivation of T. cruzi infection by close monitoring. We analyze the relationship between Chagas disease and three immunosuppressant conditions, including a description of clinical cases seen at our center, a brief review of the literature, and recommendations for the management of these patients based on our experience and on the data in the literature. T. cruzi infection is considered an opportunistic parasitic infection indicative of AIDS, and clinical manifestations of reactivation are more severe than in acute Chagas disease. Parasitemia is the most important defining feature of reactivation. Treatment with benznidazole and/or nifurtimox is strongly recommended in such cases. It seems reasonable to administer trypanocidal treatment only to asymptomatic immunosuppressed patients with detectable parasitemia, and/or patients with clinically defined reactivation. Specific treatment for Chagas disease does not appear to be related to a higher incidence of neoplasms, and a direct role of T. cruzi in the etiology of neoplastic disease has not been confirmed. Systemic immunosuppressive diseases or immunosuppressants can modify the natural course of T. cruzi infection. Immunosuppressive doses of corticosteroids have not been associated with higher rates of reactivation of Chagas disease. Despite a lack of evidence-based data, treatment with benznidazole or nifurtimox should be initiated before immunosuppression where possible to reduce the risk of reactivation. Timely antiparasitic treatment with benznidazole and nifurtimox (or with posaconazole in cases of therapeutic failure) has proven to be highly effective in preventing Chagas disease reactivation, even if such treatment has not been formally incorporated into management protocols for immunosuppressed patients. International consensus guidelines based on expert opinion would greatly contribute to standardizing the management of immunosuppressed patients with Chagas disease.

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Section: Resultsmentioning

confidence: 90%

Immunosuppression and Chagas Disease: A Management Challenge

et al. 2013

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“…Conversely, in our study, five of eight oncological patients had solid tumours. Another issue to be addressed is the fact that Chagas disease could induce neoplasia, because some observational studies have reported a higher prevalence of oesophageal carcinoma and uterine cervix leiomyoma in T. cruzi-infected populations; however, no prospective studies have confirmed this correlation [30,31].…”

Section: Discussionmentioning

confidence: 96%

Immunosuppression and Chagas disease; experience from a non-endemic country

Salvador

Sánchez-Montalvà

Valerio

et al. 2015

Clinical Microbiology and Infection

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Reactivation of Chagas disease in the chronic phase may occur when immunosuppression is established, sometimes resulting in high parasitaemia and severe clinical manifestations such as meningitis and meningoencephalitis. Although this situation is being increasingly described, there is still scarce information. This retrospective observational study was performed in three Tropical Medicine Units of Barcelona (Spain) included in the International Health Programme of the Catalan Health Institute (PROSICS). The objective of the study was to describe epidemiological, clinical, microbiological, prognostic and therapeutic data from patients with Chagas disease and any kind of immunosuppressive condition attended in these three institutions from January 2007 to October 2014. From 1823 patients with Chagas disease attending these three centres during the study period, 38 (2%) had some kind of immunosuppressive condition: 12 patients had human immunodeficiency virus infection, 8 patients had neoplasia, 4 patients underwent organ transplantation and 14 patients had an autoimmune disease. Eight (21.1%) patients had cardiac involvement, and six (15.8%) patients had gastrointestinal involvement. Acute Trypanosoma cruzi infection was detected in two Spanish patients. Thirty-one (81.6%) patients received treatment with benznidazole, of whom 17 (54.8%) had some kind of adverse event. No patient had a severe manifestation or reactivation of Chagas disease. Patients with Chagas disease under immunosuppressive conditions are being increasingly described, especially in non-endemic countries. More information about this topic is required and international consensus in the diagnosis, treatment and follow up of these patients must be established to reduce the morbidity and mortality.

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“…A case report described a patient with chagasic megaesophagus who had developed esophageal leiomyosarcoma (Adad et al, 1999). A case-control study has shown that 27% of women with uterine leiomyoma were serologically positive for CD compared to 16% of controls with other benign gynecological alterations (Murta et al, 2002). Other case reports have pointed to an association of chagasic megacolon and development of colon cancer (Adad et al, 2002, Oliveira et al, 1997).…”

Section: Paradoxical Dual Impacts Of Chagas Disease In Carcinogenesismentioning

confidence: 99%

Parasite Infection, Carcinogenesis and Human Malignancy

et al. 2017

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Cancer may be induced by many environmental and physiological conditions. Infections with viruses, bacteria and parasites have been recognized for years to be associated with human carcinogenicity. Here we review current concepts of carcinogenicity and its associations with parasitic infections. The helminth diseases schistosomiasis, opisthorchiasis, and clonorchiasis are highly carcinogenic while the protozoan Trypanosoma cruzi, the causing agent of Chagas disease, has a dual role in the development of cancer, including both carcinogenic and anticancer properties. Although malaria per se does not appear to be causative in carcinogenesis, it is strongly associated with the occurrence of endemic Burkitt lymphoma in areas holoendemic for malaria. The initiation of Plasmodium falciparum related endemic Burkitt lymphoma requires additional transforming events induced by the Epstein-Barr virus. Observations suggest that Strongyloides stercoralis may be a relevant co-factor in HTLV-1-related T cell lymphomas. This review provides an overview of the mechanisms of parasitic infection-induced carcinogenicity.

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Association of uterine leiomyoma and Chagas' disease.

Cited by 18 publications

References 19 publications

Immunosuppression and Chagas Disease: A Management Challenge

Immunosuppression and Chagas Disease: A Management Challenge

Immunosuppression and Chagas disease; experience from a non-endemic country

Parasite Infection, Carcinogenesis and Human Malignancy

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