Los anticuerpos anti-muscarínicos (anti-M2) podrían estar relacionados con alteraciones disautonómicas en la enfermedad de Chagas. Objetivo: evaluar efecto del tratamiento tripanocida sobre los anticuerpos anti-M2 en adultos chagásicos crónicos seguidos durante 24 años promedio. Estudio de cohorte retrospectivo. Infectados crónicos por T. cruzi agrupados en: A) 31 tratados con drogas tripanocidas (102 muestras post-tratamiento); B) 36 no tratados (95 muestras). Controles no chagásicos: 17 cardiópatas y 22 sanos. Pacientes tratados: 11/31(35,5%) inicialmente presentaron reactividad anti-M2; 2/31(6,4%) permanecieron reactivos durante el estudio. No tratados: 14/36(38,9%) fueron positivos al inicio y final del seguimiento. Todos los pacientes permanecieron sin cambio clínicos durante el estudio. Los controles no presentaron reactividad anti-M2. El origen de los anticuerpos anti-M2 no sería de naturaleza autoinmune ya que desaparecen por efecto del tratamiento tripanocida y por otro lado la presencia de los mismos no tendría utilidad como marcador pronóstico de evolución clínica. Palabras claves: Enfermedad de Chagas-Tratamiento tripanocida-Anticuerpos antimuscarínicos SUMMARY Chronic Chagas Disease: effect of trypanocidal treatment on antimuscarinic antibodies Anti-muscarinic antibodies (anti-M2) could be related to dysautonomic alterations in Chagas disease. Objective: evaluate effect of trypanocidal treatment on the anti-M2 antibodies in chronic chagasic adults followed for 24 years on average. Retrospective cohort study. Chronic patients infected by T. cruzi were grouped into: A)31 treated with trypanocidal drugs (102 samples post-treatment); B)36 untreated (95 samples). Controls no chagasic: 17 with cardiopathies and 22 healthy. Patients treated: 11/31(35.5%) initially presented anti-M2 reactivity; 2/31 during the study remained reactive. Untreated: 14/36(38.9%) were positive at the beginning and to the end of follow up. All patients remained without clinical change during the study. The controls no showed anti-M2 reactivity. The origin of anti-M2 antibodies would not be autoimmune as they disappear by effect of trypanocidal treatment and on the other hand the presence of them would not be useful as a prognostic marker of clinical evolution.
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