Reativação da doença de Chagas com envolvimento do sistema nervoso central durante tratamento de linfoma não Hodgkin

Oliveira, Leonardo Rodrigues de; Assis, Larissa L. T.; Maltos, André Luiz; Calil, Meire C. F; Moraes-Souza, Hélio

doi:10.1590/s1516-84842010005000080

Cited by 4 publications

(3 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Todavia, manifestações neurológicas, como meningite e encefalite, insuficiência cardíaca e morte, podem advir na fase aguda da doença, sobretudo nos imunodeprimidos 23 . A predominância absoluta de infecção assintomática, explica o pequeno número de casos de transmissão transfusional bem documentados, (aproximadamente 300), frente a uma estimativa de ocorrência anual de 20.000 casos no Brasil e mais de 4.000 na Argentina na década de 70, várias centenas na Bolívia no final dos anos 90 e mais de 1.000 casos no México no ano 2000 10,16 .…”

unclassified

O controle da transmissão transfusional

Moraes-Souza

Ferreira-Silva

2011

Rev. Soc. Bras. Med. Trop.

Self Cite

View full text Add to dashboard Cite

A alta prevalência de doadores chagásicos nos bancos de sangue do Brasil (6,9%) e da América Latina (6,5%), nas décadas de 60 e 70, aliada ao combate ao vetor a partir dos anos setenta, fez com que a doença de Chagas transfusional, a partir da década de oitenta, se tornasse o principal mecanismo de transmissão da doença na maioria dos países endêmicos. Contudo, os resultados altamente favoráveis do combate ao vetor e da cobertura sorológica dos doadores, reduziu a prevalência de soropositividade para 0,2% e 1,3%, respectivamente, no Brasil e América Latina e o índice de transmissão anual, via transfusão de sangue no Brasil, de 20.000 para 13 em quatro décadas. Entretanto, paralelamente aos grandes avanços obtidos pelos países endêmicos, a doença de Chagas alcançou, via processo migratório, os países não endêmicos da América do Norte e da Europa, além do Japão e Austrália, colocando em risco os receptores de sangue destes países e transformando a doença de Chagas num problema de saúde global. A segurança transfusional, propiciada pela triagem sorológica, trouxe, porém outro importante problema, qual seja, a alta proporção de reações inconclusivas e dois grandes desafios: o significado de tais exames e que orientação proporcionar ao doador. Contudo, as estratégias adotadas pelos países não endêmicos e os avanços alcançados pelos endêmicos, prenunciam o breve, auspicioso e intensamente sonhado controle vetorial e transfusional da doença de Chagas. Palavras-chaves: Transfusão de sangue. Doença de Chagas. Transmissão transfusional. Medidas de controle. ABSTRACTThe high prevalence of chagasic blood donors in blood centers in Brazil (6.9%) and in Latin America (6.5%) in the 60's and 70's, together with the combat to the vector since the 70's have made transfusion Chagas disease the main mechanism of the disease transmission in the 80's. However, the highly favorable results achieved to eliminate the vector and the serologic screening of blood donors, reduced the prevalence of serum positivity to 0.2% and 1.3%, respectively and the rate of annual transmission through blood transfusion from 20.000 to 13 in four decades in Brazil. Nevertheless, despite outstanding advancements in endemic countries, Chagas disease reached, via migration, non-endemic countries in North America and Europe besides Japan and Australia, placing their blood recipients at risk and turning Chagas disease into a worldwide health problem. Transfusion safety through serologic selection raised another big issue i.e. high proportion of inconclusive reactions as well as two great challenges: the meaning of such exams and what guidelines to provide the donor. However, the strategies adopted by non-endemic countries and the advancements achieved by endemics so far forecast the highly wished vector and transfusion control of Chagas disease. O processo migratório no sentido campo-cidade, com o início da industrialização do Brasil, a partir da década de cinquenta, promoveu a urbanização da doença e foi responsável pela alta prevalência de doadores chagásicos...

show abstract

unclassified

O controle da transmissão transfusional

Moraes-Souza

Ferreira-Silva

2011

Rev. Soc. Bras. Med. Trop.

Self Cite

View full text Add to dashboard Cite

show abstract

“…In addition, outside the transplant setting, CDR has been described as single case reports in 12 patients from 1968 to 2015 (Table 5), more frequently in non-Hodgkin lymphoma and Hodgkin lymphoma [37][38][39][40][41][42][43][44][45][46][47][48] . Reactivation occurred during the induction phase or chemotherapy in the majority.…”

Section: Review On Chagas Disease Reactivation and Multiple Myelomamentioning

confidence: 99%

“…The diagnosis was performed in three cases by necropsy 38,39,41 . Two patients died before 19 days of antiparasitic therapy, one by bacterial sepsis 46 and the other after interruption of benznidazole due to leukopenia 45 . Therefore, this high lethality is possibly due to late diagnosis and significant impairment of the mechanisms involved in controlling the growth of parasites both by the underlying disease and chemotherapy.…”

Section: Review On Chagas Disease Reactivation and Multiple Myelomamentioning

confidence: 99%

Multiple myeloma and Chagas disease: qPCR as a marker for preemptive antiparasitic therapy: a case reports series and review

Carvalho,

Freitas,

Seguro

et al. 2024

Rev. Inst. Med. trop. S. Paulo

View full text Add to dashboard Cite

Multiple myeloma (MM) associated with Chagas disease is rarely described. This disease and its therapy suppress T cell and macrophage functions and increase regulatory T cell function, allowing the increase of parasitemia and the risk of Chagas Disease Reactivation (CDR). We aimed to analyze the role of conventional (cPCR) and quantitative Polymerase Chain Reaction (qPCR) for prospective monitoring of T. cruzi parasitemia, searching for markers of preemptive antiparasitic therapy in MM patients with Chagas disease. Moreover, we investigated the incidence and management of hematological diseases and CDR both inside and outside the transplant setting in the MEDLINE database. We found 293 studies and included 31 of them. Around 1.9–2.0% of patients with Chagas disease were reported in patients undergoing Stem Cell Transplantation. One case of CDR was described in eight cases of MM and Chagas disease . We monitored nine MM and Chagas disease patients, seven under Autologous Stem Cell Transplantation (ASCT), during 44.56±32.10 months (mean±SD) using parasitological methods, cPCR, and qPCR. From these patients, three had parasitemia. In the first, up to 256 par Eq/mL were detected, starting from 28 months after ASCT. The second patient dropped out and died soon after the detection of 161.0 par Eq/mL. The third patient had a positive blood culture. Benznidazole induced fast negativity in two cases; followed by notably lower levels in one of them. Increased T. cruzi parasitemia was related to the severity of the underlying disease. We recommend parasitemia monitoring by qPCR for early introduction of preemptive antiparasitic therapy to avoid CDR.

show abstract