Inflammation and glandular duct dilatation of the tongue from patients with chronic Chagas disease

Abstract

The purpose of this study was to evaluate morphologically the tongue of individuals with chronic Chagas disease (CD) in comparison to the non-chagasic ones. Twenty-four protocol cases of autopsies were selected. They were subdivided into CD patients (10 cases) and non-chagasic ones (14 cases). The morphometric analysis was accomplished for the tongue muscle and salivary glands duct lumen area. In three CD patients, perineuritis was found, and two of them showed megaesophagus and megacolon. The intensity of the inflammation in the von Ebner's glands, the tongue muscles, and the salivary glands duct lumen area was significantly higher in the CD patients. We concluded that the CD patients show salivary glands duct dilatation, which probably would have a relation with alterations in the autonomic nervous system. The inflammation found in CD patients is in accordance with that described in comparative studies on the digestive tract and heart. These morphological findings suggest that the histopathological analysis of the tongue associated with other organs, or even in an isolated manner, can add in the diagnosis and pathogenesis of the CD chronic phase.

Comparison between the collagen intensity and mast cell density in the lingual muscles and myocardium of autopsied chronic chagasic and nonchagasic patients

“…In the lingual muscle of the chagasic patient group, there was a significantly higher percentage of collagen when compared with the nonchagasic patient group, which is consistent with a previous study by our group, in which more fibrosis was shown in the tongue muscles of CD patients than nonchagasic patients (de Lima Pereira et al 2006). In the present study, the chagasic patient group showed a higher collagen density in the lingual muscles when compared with the myocardium.…”

“…Positive staining for MCT was observed in the lingual musculature from the chagasic patient group (c) and nonchagasic patient group (d) (×1,600) inflammatory disease, the highest MCT density in the chagasic patient group found in this study could have occurred as a response to T. cruzi antigens and collaborated with changes in the microcirculation of chronic inflammation responsible for the persistent response to the parasite. In a previous study, greater intensity of inflammation in the muscles of the tongue of patients with CD was shown, when compared with patients without CD (de Lima Pereira et al 2006). In the present study, the chagasic patient group had significantly higher MCT density in the lingual muscles when compared with nonchagasic patients, which suggests that in CD, MCT also plays a role in the inflammation of the lingual muscles.…”

“…In CD, human collagen deposition has been demonstrated in various organs, such as the heart (Palomino et al 2000;Rossi 2001;López et al 2006), pancreas (Saldanha et al 2001), spleen (Pereira et al 2002), esophagus (Cabral 2000), colon (Pinheiro et al 2003), and tongue (de Lima Pereira et al 2006). When the collagen densities in the myocardium and tongue were analyzed together, the chagasic patient group showed a significant increase in collagen density when compared with the nonchagasic patient group, which is consistent with other studies in patients with chronic CD who were shown to have more collagen in the organs infected with T. cruzi (Coura and Borges-Pereira 2010).…”

“…In addition to the heart muscles, other muscles can be infected in human CD, such as the gastrocnemius (Lugo de Yarbuh et al 2006) and lingual muscles (Barbosa and Andrade 1984). Recent studies by our group have shown that the tongues of individuals with CD exhibit more significant morphological changes when compared with patients without CD (de Lima Pereira et al 2006Pereira et al , 2007Pereira et al , 2009.…”

Lingual salivary gland hypertrophy and decreased acinar density in chagasic patients without megaesophagus

“…On the other hand, it has already been demonstrated, in the chronic phase of CD, dilation of parotid glands 4 , submandibular glands and sublingual glands 5 . Similarly, a study by our group showed that the lingual salivary glands of patients with chronic CD present a higher number of alterations when compared to non-chagasic patients, such as ductal dilation, inflammatory infiltrate, perineuritis and myositis 6 .…”