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Myocardial parasite persistence in chronic chagasic patients.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 1999 May; Vol. 60 (5), pp. 726-32. - Publication Year :
- 1999
-
Abstract
- The persistence of Trypanosoma cruzi tissue forms was detected in the myocardium of seropositive individuals clinically diagnosed as chronic chagasic patients following endomyocardial biopsies (EMBs) processed by immunohistochemical (peroxidase-anti-peroxidase [PAP] staining) and molecular (polymerase chain reaction [PCR]) techniques. An indirect immunofluorescent technique revealed antigenic deposits in the cardiac tissue in 24 (88.9%) of 27 patients. Persistent T. cruzi amastigotes were detected by PAP staining in the myocardium of 22 (84.6%) of 26 patients. This finding was confirmed with a PCR assay specific for T. cruzi in 21 (91.3%) of 23 biopsy specimens from the same patients. Statistical analysis revealed substantial agreement between PCR and PAP techniques (k = 0.68) and the PCR and any serologic test (k = 0.77). The histopathologic study of EMB specimens from these patients revealed necrosis, inflammatory infiltrates, and fibrosis, and made it possible to detect heart abnormalities not detected by electrocardiogram and/or cineventriculogram. These indications of myocarditis were supported by the detection of T. cruzi amastigotes by the PAP technique or its genome by PCR. They suggest that although the number of parasites is low in patients with chronic Chagas' disease, their potential for heart damage may be comparable with those present during the acute phase. The urgent necessity for testing new drugs with long-term effects on T. cruzi is discussed in the context of the present results.
- Subjects :
- Adult
Animals
Antigens, Protozoan immunology
Biopsy
Chagas Cardiomyopathy pathology
Chronic Disease
DNA, Protozoan analysis
Endocardium pathology
Female
Humans
Immunohistochemistry
Male
Middle Aged
Myocardium pathology
Polymerase Chain Reaction methods
Trypanosoma cruzi genetics
Chagas Cardiomyopathy parasitology
Heart parasitology
Trypanosoma cruzi isolation & purification
Subjects
Details
- Language :
- English
- ISSN :
- 0002-9637
- Volume :
- 60
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 10344642
- Full Text :
- https://doi.org/10.4269/ajtmh.1999.60.726