Moléstia de chagas crônica associada a leucemia linfática: ocorrência de encefalite aguda como alteração do estado imunitário

Abstract

É relatado um caso de paciente apresentando a forma crônica da doença de Chagas, no qual foi observada a presença de encefalite chagásica aguda, com demonstração de leishmanias no sistema nervoso central. O caso é único na literatura, sendo interpretado como devido a agravamento da forma crônica da doença de Chagas pela presença de leucemia linfática crônica associada. A existência de leucemia linfática pode levar à extinção de clones linfocitários responsáveis por fenômenos imunitários, criando, assim, condições para o agravamento e agudização da forma crônica da doença de Chagas.

2 nd Brazilian Consensus on Chagas Disease, 2015

“…Reactivation of Chagas disease was first reported in patients immunocompromised by hematologic neoplasms (176) . From the late 1980s and early 1990s, cases of reactivation of Chagas disease began to be reported in HIV-infected individuals (159) (175) (177) (178) (179) (180) .…”

Chagas’ disease reactivation with skin symptoms in a patient with kidney transplant

“…There have been reported cases of the reactivation of Chagas’ disease in patients with AIDS and leukemia 15,16 . In patients with AIDS, it may cause meningoencephalitis with the presence of brain abscesses 14,17,18 .…”

Some Aspects of Protozoan Infections in Immunocompromised Patients: A Review

“…Some cases have been described in Brazil (Amato Neto et al 1968, França et al 1969, Queiroz 1973, others in Latin-American countries where the parasitosis is endemic (Rivero et al 1974, Monte Verde et al 1976, Pizzi et al 1982, and one case was documented in the United States (Kohl et al 1982). Usually, severe manifestations of trypanosomiasis that occurs in immunosuppressed patients result in the reactivation of chronic, previously asymptomatic or oligosymptomatic infection, although severe acute forms resulting from blood transfusions have sporadically been reported in the literature (Corona et al 1988, Wanderley et al 1988, Grant et al 1989, Nickersosn et al 1989.…”