Chagasic megaesophagus and megacolon diagnosed in childhood and probably caused by vertical transmission

Da-Costa-Pinto, Elizete Aparecida Lomazi; Almeida, Eros Antônio de; Figueiredo, Deolinda de Matos; Bucaretchi, Fábio; Hessel, Gabriel

doi:10.1590/s0036-46652001000400010

Cited by 8 publications

(4 citation statements)

References 10 publications

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“…Although dilation of the GI tract is not generally appreciated as a finding in acute human infection, it has been described as a consequence of congenital Chagas disease 41,42. Thus, our observations indicate that T. cruzi associated megasyndromes of the GI tract may appear much earlier than previously appreciated and suggests that individuals with Chagas disease at any stage should be evaluated for GI abnormalities.…”

Section: Discussionmentioning

confidence: 45%

A Magnetic Resonance Imaging Study of Intestinal Dilation in Trypanosoma cruzi–infected Mice Deficient in Nitric Oxide Synthase

Ny¹,

Li²,

Mukherjee³

et al. 2008

The American Journal of Tropical Medicine and Hygiene

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Infection with Trypanosoma cruzi causes megasyndromes of the gastrointestinal (GI) tract. We used magnetic resonance imaging (MRI) to monitor alterations in the GI tract of T. cruzi-infected mice, and to assess the role of nitric oxide (NO) in the development of intestinal dilation. Brazil strain-infected C57BL/6 wild-type (WT) mice exhibited dilatation of the intestines by 30 days post-infection. Average intestine lumen diameter increased by 72%. Levels of intestinal NO synthase (NOS) isoforms, NOS2 and NOS3, were elevated in infected WT mice. Inflammation and ganglionitis were observed in all infected mice. Intestinal dilation was observed in infected WT, NOS1, NOS2, and NOS3 null mice. This study demonstrates that MRI is a useful tool to monitor intestinal dilation in living mice and that these alterations may begin during acute infection. Furthermore, our data strongly suggests that NO may not be the sole contributor to intestinal dysfunction resulting from this infection.

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Section: Discussionmentioning

confidence: 45%

A Magnetic Resonance Imaging Study of Intestinal Dilation in Trypanosoma cruzi–infected Mice Deficient in Nitric Oxide Synthase

Ny¹,

Li²,

Mukherjee³

et al. 2008

The American Journal of Tropical Medicine and Hygiene

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“…26 Most of the diagnoses were made at birth or within one month of age (n=8); however, timing of diagnosis ranged from prenatal 27 to 7 years of age. 28 The method of diagnosis was mixed in all but one case, where only serology was used. 29 Nine case reports included direct microscopy in combination with serology, PCR, culture, xenodiagnosis, and/or symptomatology.…”

Section: Resultsmentioning

confidence: 99%

Frequency of the congenital transmission of Trypanosoma cruzi: a systematic review and meta‐analysis

Howard

Xiong

Carlier

et al. 2013

BJOG

211

138

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Background Chagas disease is caused by the parasite Trypanosoma cruzi and endemic in much of Latin America. With increased globalization and immigration, it is a risk in any country due in part to congenital transmission. The frequency of congenital transmission is unclear. Objective To assess the frequency of congenital transmission of T. cruzi. Search Strategy PubMed, Journals@Ovid Full Text, EMBASE, CINAHL, Fuente Academica and BIREME databases were searched using seven search terms related to Chagas disease or Trypanosoma cruzi and congenital transmission. Selection Criteria The inclusion criteria were the following: Dutch, English, French, Portuguese or Spanish language; case report, case series or observational study; original data on congenital T. cruzi infection in humans; congenital infection rate reported or it could be derived. This systematic review included 13 case reports/series and 51 observational studies. Data Collection and Analysis Two investigators independently collected data on study characteristics, diagnosis and congenital infection rate. The principal summary measure – the congenital transmission rate – is defined as the number of congenitally infected infants divided by the number of infants born to infected mothers. A random effects model was utilized. Main Results The pooled congenital transmission rate was 4.7% (95% confidence interval: 3.9–5.6%). Endemic countries had a higher rate of congenital transmission compared to non-endemic (5.0% vs. 2.7%). Conclusions Congenital transmission of Chagas disease is a global problem. Overall risk of congenital infection in infants born to infected mothers is about 5%. The congenital mode of transmission requires targeted screening to prevent future cases of Chagas disease.

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“…The disease ends with a megaesophagus and megacolon (the megasyndrome) due to the destruction of the submucosal (Meissner) and the myenteric (Auerbach) nerve plexuses. 1,[3][4][5]13,14 Patients with chagasic megacolon present with severe and prolonged constipation for long periods (up to 60 d), or even for decades in the worst cases. 3 Lipoid pneumonia is a potential complication of CD, particularly in patients using mineral oil, as the most common cause of lipoid pneumonia is the use of mineral oil for the treatment of constipation.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3][4] Although its incidence is declining, an impressive number of individuals still suffer from this disease, 1 and it has a wide distribution in Central and South America. It has been reported in all countries in the Americas, except in Canada.…”

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confidence: 99%

Lipoid Pneumonia Complicating Megaesophagus Secondary to Chagas Disease

Marchiori

Zanetti

Nobre

et al. 2010

Journal of Thoracic Imaging

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Chagasic megaesophagus and megacolon diagnosed in childhood and probably caused by vertical transmission

Cited by 8 publications

References 10 publications

A Magnetic Resonance Imaging Study of Intestinal Dilation in Trypanosoma cruzi–infected Mice Deficient in Nitric Oxide Synthase

A Magnetic Resonance Imaging Study of Intestinal Dilation in Trypanosoma cruzi–infected Mice Deficient in Nitric Oxide Synthase

Frequency of the congenital transmission of Trypanosoma cruzi: a systematic review and meta‐analysis

Lipoid Pneumonia Complicating Megaesophagus Secondary to Chagas Disease

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