Symptoms Associated With Different Degrees of Megaesophagus in Chagas Disease

Oliveira, Jaline de Araujo; Gharib, Aretuza Zaupa Gasparim El; Dantas, Roberto Oliveira

doi:10.1590/s0004-2803.202100000-88

Cited by 3 publications

(4 citation statements)

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“…The findings of the esophagogram in patients with achalasia may not reflect their reported esophageal symptoms and may not affect their HRQoL. Recently, Oliveira et al (35) did not find a correlation between Grades of megaesophagus (by esophagogram) and frequency of esophageal symptoms nor the intensity of dysphagia in ChA patients. Laurindo-Neto et al (34) observed that Chagas as well as Idiopathic Achalasia patients reported several esophageal symptoms even in early stages of the disease.…”

Section: Discussionmentioning

confidence: 93%

Impaired Quality of Life in Chagas Acalasia Patients and Associated Clinical Factors

Rosa-e-Silva

Pontes

VENDRAME

et al. 2022

Arq. Gastroenterol.

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Background: No study has focused on Health-Related Quality of Life (HRQoL) for Chagas Achalasia patients. Objective: To compare HRQoL between Chagas Achalasia patients and the general population; and to correlate HRQoL with clinical factors that can affect it. Methods: Sixty Chagas Achalasia patients and 50 controls were evaluated. All patients underwent esophageal manometry for the diagnosis of achalasia and esophagogram to determine the grade of megaesophagus. Three questionnaires were used: 1) clinical: the following data were collected: demographic, medical history, body mass index, occurrence of six esophageal symptoms (Esophageal Symptom Score: number of symptoms reported by patients), duration of dysphagia; 2) socio-economic-cultural status evaluation: patients and controls answered seven questions about their socio-economic-cultural conditions; 3) HRQoL: the validated Brazilian-Portuguese version of the Short-form Health Survey (SF-36) questionnaire (license QM020039) was used. It measures health in eight domains: 3a) four physical: physical functioning, role limitations relating to physical health, bodily pain, and general health perception; 3b) four mental: vitality, social functioning, role limitations relating to emotional health, and mental health. These domains can be summarized into Physical and Mental Summary scores. We analyzed correlations between SF-36 Physical/Mental Summary Component scores and the following clinical factors: Esophageal Symptom Score, duration of dysphagia, body mass index, grades of megaesophagus (defined by the esophagogram) and presence/absence of megacolon (defined by opaque enema). Results: Patients and controls had similar age, gender, medical history, and socio-economic-cultural lifestyles (P>0.05). All patients had dysphagia and megaesophagus. SF-36 scores were significantly lower in Chagas Achalasia patients than controls for all eight domains (physicals: P<0.002; mentals: P<0.0027). The Physical and Mental Summary Component scores were also lower in Chagas Achalasia patients than controls (P<0.0062). For patients, the Physical Summary score was negatively correlated to Esophageal Symptom Score (P=0.0011) and positively correlated to body mass index (P=0.02). No other correlations were found. Conclusion: Chagas Achalasia patients have an impaired HRQoL in all physical and mental domains. Patients reporting more symptoms had worse physical domains. Patients with higher body mass index had better physical domains.

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Section: Discussionmentioning

confidence: 93%

Impaired Quality of Life in Chagas Acalasia Patients and Associated Clinical Factors

Rosa-e-Silva

Pontes

VENDRAME

et al. 2022

Arq. Gastroenterol.

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“…23 Dysphagia is the most common and first symptom seen in CDE but may not always correlate to the degree of megaesophagus seen radiologically. [17][18][19][20][21][22][23] Regurgitation, weight loss, dyspepsia, increased thirst, chest discomfort, and cough are all associated symptoms of CDE, so a thorough review of symptoms should be undertaken in all those with serological evidence of CD. [17][18][19][20][21][22][23] One limitation of this case report is that our patient did receive a short course (6 weeks; 50 Gy) of IMRT for 0.4-cm invasive ductal carcinoma (TIaN0M0) in 2016 after lumpectomy.…”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20][21][22][23] Regurgitation, weight loss, dyspepsia, increased thirst, chest discomfort, and cough are all associated symptoms of CDE, so a thorough review of symptoms should be undertaken in all those with serological evidence of CD. [17][18][19][20][21][22][23] One limitation of this case report is that our patient did receive a short course (6 weeks; 50 Gy) of IMRT for 0.4-cm invasive ductal carcinoma (TIaN0M0) in 2016 after lumpectomy. She did not experience acute radiation-induced esophagitis during this treatment or receive concomitant chemotherapy, which has been described in those who develop late-onset esophageal toxicity.…”

Section: Discussionmentioning

confidence: 99%

“…However, those with CDE often present with varying degrees of esophageal dysmotility seen on HREM, which is likely related to the evolution of autonomic dysregulation seen in CDE. 16 – 21 One investigation of 62 patients confirmed with chronic CD living in Spain found that 22.6% ( n = 14/62) had pathologic HREM findings consistent with CDE prior to antitrypanosomal treatment. 22 Most ( n = 13/14) were diagnosed with IEM, and 1 patient was diagnosed with fragmented peristalsis.…”

Section: Discussionmentioning

confidence: 99%

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Case Report: Chagas Disease in a Traveler Who Developed Esophageal Involvement Decades after Acute Infection

Beatty

Alcala

Radetic

et al. 2023

The American Journal of Tropical Medicine and Hygiene

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Travelers to Chagas disease endemic regions of Latin America may be at risk for Trypanosoma cruzi infection. We report a 67-year-old woman who screened positive for T. cruzi infection while donating blood. The patient had a history of an unusual febrile illness and marked swelling of the face sustained at age 10 after camping in northern Mexico that led to a 3-week hospitalization without a diagnosis. More than 4 decades later, rapid diagnostic tests and commercial and confirmatory serology for Chagas disease were all positive for T. cruzi infection. On evaluation, the patient described a progressive chronic cough, gastroesophageal reflux, and dysphagia for > 10 years. There was no evidence of any cardiac complications. However, esophageal manometry demonstrated significant dysmotility, with 90% of swallows being ineffective with evidence of esophageal pressurization and retrograde peristalsis in several swallows, suggesting early autonomic disruption due to Chagas disease esophagopathy. In this report, we highlight the importance of travel-related Chagas disease among travelers to endemic regions and the need to further identify potential risks of transmission among this at-risk population.

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