Reactivation of chronic Chagas’ disease following allogeneic bone marrow transplantation and successful pre‐emptive therapy with benznidazole

Altclas, Javier; Sinagra, Angel; Jaimovich, Gregorio; Salgueira, Claudia; Luna, C; Requejo, Alejandro; Milovic, Vera; Rissio, A De; Feldman, Leonardo; Riarte, Adelina

doi:10.1034/j.1399-3062.1999.010207.x

Cited by 33 publications

(27 citation statements)

References 17 publications

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“…21 Heart and bone marrow transplants associated with CD were also reported in the US 22 and Spain. 23 In this report, we included all patients submitted to BMT in four centers from Argentina; all patients were monitored with the same prospective protocol during a 10-year period in order to evaluate if the preemptive therapy strategy was an effective approach to detect early CD reactivation (Dictar et al, 10 Altclas et al, 11 and E Efron, R Jorda´n and J Martinez, unpublished data) or CD primary infection.…”

Section: Discussionmentioning

confidence: 99%

Chagas disease in bone marrow transplantation: an approach to preemptive therapy

Altclas

Sinagra

Dictar

et al. 2005

Bone Marrow Transplant

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Summary:The efficacy of preemptive therapy was evaluated in bone marrow transplantation (BMT) recipients associated with Chagas disease (CD). The criterion to include patients in the protocol was the serological reactivity for CD in recipients and/or donors before transplant. After BMT, the monitoring was performed using the direct Strout method (SM), which detects clinical levels of Trypanosome cruzi parasitemia, and CD conventional serological tests. Monitoring took place during 60 days in ABMT and throughout the immunosuppressive period in allogeneic BMT. Reactivation of CD was diagnosed by detecting T. cruzi parasites in blood or tissues. In primary T. cruzi infection, an additional diagnostic criterion was the serological conversion. A total of 25 CD-BMT patients were included. Two ABMT and four allogeneic BMT recipients showed CD recurrences diagnosed by SM. One patient also showed skin lesions with T. cruzi amastigotes. Benznidazole treatment (Roche Lab), an antiparasitic drug, was prescribed at a dose of 5 mg/kg/day during 4-8 weeks with recovery of patients. Primary T. cruzi infection was not observed. This report proves the relevance of monitoring CD in BMT patients and demonstrates that preemptive therapy was able to abrogate the development of clinical and systemic disease.

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Section: Discussionmentioning

confidence: 99%

Chagas disease in bone marrow transplantation: an approach to preemptive therapy

Altclas

Sinagra

Dictar

et al. 2005

Bone Marrow Transplant

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“…infection, malaria, and syphilis (208). In immunosuppressed patients posttransplantation, discordant results using different serological techniques have been reported (5,104,310), and this has also been noted in patients with viral infections and AIDS. Although not specifically used in immunocompromised patients, new techniques using T. cruzi excretedsecreted antigens are under development (416) Tests based on T. cruzi excreted-secreted antigens (ELISA and WB) have shown high sensitivity and specificity in the diagnosis of acute and chronic infection by T. cruzi (373), without cross-reactivity with other diseases (341).…”

Section: Diagnostic Methods (I) Parasitological Methodsmentioning

confidence: 98%

“…21,2008 TRANSMISSION OF INFECTIONS DURING SOLID-ORGAN TRANSPLANT 79 on April 7, 2019 by guest http://cmr.asm.org/ the first week posttransplantation and performed weekly for the first month, fortnightly for the next 3 months, and monthly thereafter are recommended (5,104,310). Immediate treatment with benznidazole for 30 to 60 days or nifurtimox for 90 to 120 days should be started upon finding evidence of infection.…”

Section: Diagnostic Methods (I) Parasitological Methodsmentioning

confidence: 99%

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

et al. 2008

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SUMMARY In recent years, the increasing number of donors from different regions of the world is providing a new challenge for the management and selection of suitable donors. This is a worldwide problem in most countries with transplantation programs, especially due to the increase in immigration and international travel. This paper elaborates recommendations regarding the selection criteria for donors from foreign countries who could potentially transmit tropical or geographically restricted infections to solid-organ transplant recipients. For this purpose, an extensive review of the medical literature focusing on viral, fungal, and parasitic infections that could be transmitted during transplantation from donors who have lived or traveled in countries where these infections are endemic has been performed, with special emphasis on tropical and imported infections. The review also includes cases described in the literature as well as risks of transmission during transplantation, microbiological tests available, and recommendations for each infection. A table listing different infectious agents with their geographic distributions and specific recommendations is included.

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“…Reactivation syndromes may present as acute myocarditis or meningoencephalitis. Not uncommonly, however, patients present with fever and cutaneous lesions 28 . The cutaneous lesions are most commonly erythematous nodules or plaques.…”

Section: Reactivationmentioning

confidence: 99%

“…2–4). Reactivation with cutaneous manifestations has been described following kidney transplantation, 29,30 bone marrow transplantation, 28 cardiac transplantation, 31,32 and liver transplantation 33 . A similar presentation has been described in patients with HIV/AIDS 3 …”

Section: Reactivationmentioning

confidence: 99%

Trypanosoma cruzi infection: a review with emphasis on cutaneous manifestations

2012

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Chagas disease, an infection caused by the protozoan Trypanosoma cruzi and transmitted by the Reduuvid insect vector, remains a major cause of morbidity in Central and South America over a century after its discovery in 1909. Though major advances in preventing the spread of this disease have been made in recent decades, millions of individuals remain chronically infected due to prior exposure to T. cruzi and are at risk for future complications from the disease. Dermatologic manifestations of acute infection may include localized swelling at the site of inoculation (chagoma), conjunctivitis (Romaña’s sign), and a generalized morbilliform eruption (schizotrypanides). Reactivation of quiescent infection in immunocompromised hosts due to the acquired immunodeficiency syndrome or organ transplantation can present with fever and skin lesions including panniculitis. The wide-spread emigration of chronic carriers of T. cruzi to North America, Europe, and Australia makes it imperative that dermatologists worldwide be familiar with this entity to ensure proper diagnosis and treatment.

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Reactivation of chronic Chagas’ disease following allogeneic bone marrow transplantation and successful pre‐emptive therapy with benznidazole

Cited by 33 publications

References 17 publications

Chagas disease in bone marrow transplantation: an approach to preemptive therapy

Chagas disease in bone marrow transplantation: an approach to preemptive therapy

Transmission of Tropical and Geographically Restricted Infections during Solid-Organ Transplantation

Trypanosoma cruzi infection: a review with emphasis on cutaneous manifestations

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