Clinical and nutritional profile of individuals with chagas disease

Geraix, Juliana; Ardisson, Lidiane P.; Marcondes-Machado, Jussara; Pereira, Paulo Câmara Marques

doi:10.1590/s1413-86702007000400008

Cited by 28 publications

(21 citation statements)

References 16 publications

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“…Similarly, it has been reported that chagasic individuals residing in non-endemic areas of Brazil also manifested overweight [28], likely due to changes in their eating habits when migrating from endemic areas to large cities [29]. Within this setting, present patient series had increased insulin, triglycerides, HOMA-IR index in presence of lower levels of HDL likely compatible with a prediabetic situation, which in turn may increase the risk for cardiovascular disorders.…”

Section: Discussionsupporting

confidence: 59%

Dysregulated Network of Immune, Endocrine and Metabolic Markers is Associated to More Severe Human Chronic Chagas Cardiomyopathy

González

Villar

D’Attilio

et al. 2018

Neuroimmunomodulation

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Individuals who are infected with Trypanosoma cruzi develop chronic Chagas cardiomyopathy (CCC), which is a complication involving a series of immune pathogenetic mechanisms, although an association between immune and metabolic alterations was more recently proposed. Accordingly, we investigated the immuno-metabolic response in chagasic patients and their possible influence on CCC pathogenesis. To this end, T. cruzi-seropositive (asymptomatic or with CCC) and sero-negative individuals were studied. Serum tumour necrosis factor (TNF)-α, interleukin (IL)-6, adipocytokines and the expression of their receptors in peripheral blood mononuclear cell (PBMC) were evaluated, together with other factors influencing the immune response. CCC patients showed major metabolic and hormonal abnormalities, in parallel with increased IL-6 and leptin serum levels. TNF-α receptor s, leptin and adiponectin receptors (ObR and Adipo-Rs respectively), as well as PPAR-γ expression in PBMCs from CCC patients were compatible with a counteracting response leading to an unfavourable immune-metabolic profile. These results suggest that persistently increased levels of immune-metabolic pro-inflammatory mediators along with the adverse endocrine anti-inflammatory response of CCC individuals, may contribute to the underlying mechanisms dealing with myocardial tissue damage.

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Section: Discussionsupporting

confidence: 59%

Dysregulated Network of Immune, Endocrine and Metabolic Markers is Associated to More Severe Human Chronic Chagas Cardiomyopathy

González

Villar

D’Attilio

et al. 2018

Neuroimmunomodulation

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“…Even if in recent studies [13] dysphagia appeared as a specific and constant symptom in patients with megaesophagus, in general the symptoms of chronic digestive CD are non-specific, and there are numerous confounders, including other common infections [14], [15], megacolon at high altitude, and gastrointestinal problems related to the long-term consumption of coca leaves [16]–[18] or to migration-related changes in diet [19], [20] and stress. A diagnosis of CD may easily be missed if symptoms are not evaluated by a physician who knew of the epidemiology and the symptoms of the disease.…”

Section: Introductionmentioning

confidence: 99%

Characterization of Digestive Involvement in Patients with Chronic T. cruzi Infection in Barcelona, Spain

et al. 2014

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BackgroundDigestive damage due to Chagas disease (CD) occurs in 15–20% of patients diagnosed as a result of peristaltic dysfunction in some endemic areas. The symptoms of chronic digestive CD are non-specific, and there are numerous confounders. Diagnosis of CD may easily be missed if symptoms are not evaluated by a well trained physician. Regular tests, as barium contrast examinations, probably lack the necessary sensitivity to detect early digestive damage.Methods71 individuals with T. cruzi infection (G1) and 18 without (G2) coming from Latin American countries were analyzed. They were asked for clinical and epidemiological data, changes in dietary habits, and history targeting digestive and cardiac CD symptoms. Serological tests for T. cruzi, barium swallow, barium enema, an urea breath test, and esophageal manometry were requested for all patients.Principal findingsG1 and G2 patients did not show differences in lifestyle and past history. Fifteen (21.1%) of G1 had digestive involvement. Following Rezende criteria, esophagopathy was observed in 8 patients in G1 (11.3%) and in none of those in G2. Manometry disorders were recorded in 34 G1 patients and in six in G2. Isolated hypotensive lower esophageal sphincter (LES) was found in sixteen G1 patients (23.9%) and four G2 patients (28.8%). Achalasia was observed in two G1 patients. Among G1 patients, ineffective esophageal motility was seen in six (five with symptoms), diffuse esophageal spasm in two (one with dysphagia and regurgitation), and nutcracker esophagus in three (all with symptoms). There were six patients with hypertonic upper esophageal sphincter (UES) among G1. Following Ximenes criteria, megacolon was found in ten G1 patients (13.9%), and in none of the G2 patients.ConclusionsThe prevalence of digestive chronic CD in our series was 21.1%. Dysphagia is a non-pathognomonic symptom of CD, but a good marker of early esophageal involvement. Manometry could be a useful diagnostic test in selected cases, mainly in patients with T. cruzi infection and dysphagia in whose situation barium swallow does not evidence alterations. Constipation is a common but non-specific symptom that can be easily managed. Testing for CD is mandatory in a patient from Latin America with constipation or dysphagia, and if diagnosis is confirmed, megacolon and esophageal involvement should be investigated.

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“…cruzi, em comparação aos não infectados 19 . Por outro lado, a análise dos dados de 66 pacientes adultos com sorologia positiva para doença de Chagas, atendidos no ambulató-rio da Faculdade de Medicina de uma universidade brasileira, demonstrou elevado percentual de obesidade (62%), avaliada pelo IMC, e de risco cardiovascular (55%), avaliado pelo elevado valor da CC 20 .…”

Section: Discussionunclassified

Aspectos nutricionais associados à infecção crônica pelo Trypanosoma cruzi (Chagas 1909) entre idosos: Projeto Bambuí

Santos¹,

Lima‐Costa²,

Peixoto³

2013

Cad. Saúde Pública

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Clinical and nutritional profile of individuals with chagas disease

Cited by 28 publications

References 16 publications

Dysregulated Network of Immune, Endocrine and Metabolic Markers is Associated to More Severe Human Chronic Chagas Cardiomyopathy

Dysregulated Network of Immune, Endocrine and Metabolic Markers is Associated to More Severe Human Chronic Chagas Cardiomyopathy

Characterization of Digestive Involvement in Patients with Chronic T. cruzi Infection in Barcelona, Spain

Aspectos nutricionais associados à infecção crônica pelo Trypanosoma cruzi (Chagas 1909) entre idosos: Projeto Bambuí

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