Chagas' disease is caused by the protozoan Trypanosoma cruzi which infects 10-15 million people in endemic areas throughout Latin America and is naturally transmitted by insect vectors of the family Reduviidae. Infection can also occur by congenital passage, oral ingestion, laboratory accident, and in organ transplants and blood transfusions. There are 3 life-cycle forms of T. cruzi. Epimastigotes multiply in the midgut of the insect vector, differentiate in the hind-gut into infectious trypomastigotes, patients who die of unrelated causes have identical (but less intense) lesions. Responses against T. cruzi antigens, their immunoregulation, and responses against related idiotypes (Ids) correlate with the presence of the different clinical forms of the infection. Although there are numerous findings of autoimmune lymphocyte and antibody reactivities in chagasic patients, a causal relationship is always difficult to prove. Chagasic patients' peripheral blood mononuclear cells (PBMC) respond to T. cruzi epimastigote antigens (EPI) with varying vigor. Almost all low responders are Cpatients, and their responses are usually augmented by removal of adherent macrophage suppressor cells or the addition of indomethacin. Chronic I-patients are medium or high responders, and exhibit little adherent cell-mediated immunoregulation. Western blotting