Chagas disease reactivation in rheumatologic patients: association with immunosuppressive therapy and humoral response.

Abstract:

:Evidence for Chagas disease reactivation (CDR) in rheumatologic patients under rheumatologic treatments (RTs) is scarce. To screen and follow-up patients with rheumatic diseases and concomitant Chagas disease under RT to detect CDR and to describe a possible relationship between CDR and specific RT. An observational, longitudinal, prospective, consecutive study was carried out between 2018 and 2020. Included patients were evaluated during the follow-up for clinical and laboratorial manifestations of CDR. Direct blood parasitological examination (Strout method) and polymerase chain reaction (PCR) were employed to diagnose CDR. The dynamic of anti-T. cruzi-specific antibodies was also assessed by IHA and ELISA (total IgG and Anti-SAPA). Fifty-one patients were included (86% women). Rheumatoid arthritis was the predominant disease (57%). Classic DMARDs (86.3%) and corticosteroids (61%) were the most frequent RT. CDR was developed in 6 patients (11.7%), exhibiting both positive Strout and PCR. Symptomatic reactivation of CD (fever, asthenia, arthralgias, myalgias) occurred in two patients who had previously been diagnosed with it. Regardless of the different RT, all patients who experienced CDR had previously received more than ≥ 20 mg/day of prednisone equivalent. Despite immunosuppression, patients with CDR exhibited increased levels of specific anti-T. cruzi and anti-SAPA antibodies, which decreased after anti-parasitic treatment. CDR is possible in rheumatologic patients, especially after receiving high doses of corticosteroids. Since CDR symptoms may mimic rheumatic disease activity, monitoring of Chagas disease is highly recommended before, during and after immunosuppression. Key Points • Chagas disease reactivation (CDR) in the context of rheumatological treatment was associated to high doses of corticosteroids. • CDR was associated with an increase in anti-T. cruzi antibodies despite the immunosuppressive treatment. • Suspecting and anticipating CDR is mandatory in this patient population to diagnose and treat it.

journal_name

Clin Rheumatol

journal_title

Clinical rheumatology

authors

Ringer A,Ruffino JP,Leiva R,Cuadranti N,Argento MC,Martínez MF,Rolla I,Chulibert S,Carbone D,Palatnik M,Cortese MN,Lagrutta M,Córdoba L,González FB,Pacini MF,Villar SR,Águila D,Bottasso OA,Pérez AR,Abdala M

doi

10.1007/s10067-021-05581-2

subject

Has Abstract

pub_date

2021-01-12 00:00:00

eissn

0770-3198

issn

1434-9949

pii

10.1007/s10067-021-05581-2

pub_type

杂志文章
  • Association of antiphospholipid antibodies with valvulopathy in systemic lupus erythematosus: a systematic review.

    abstract::Over the last few years, several studies in patients with systemic lupus erythematosus (SLE) have demonstrated an association between valvulopathy, including Libman-Sacks endocarditis (LS) and the presence of antiphospholipid antibodies (aPL), suggesting a role of these antibodies in the pathogenesis of the lesions. O...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/s10067-010-1662-5

    authors: Mattos P,Santiago MB

    更新日期:2011-02-01 00:00:00

  • Progressive fibrosing interstitial lung disease associated with systemic autoimmune diseases.

    abstract::Interstitial lung disease (ILD) is a common manifestation of systemic autoimmune diseases and a leading cause of death in these patients. A proportion of patients with autoimmune ILDs develop a progressive fibrosing form of ILD, characterized by increasing fibrosis on high-resolution computed tomography, worsening of ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/s10067-019-04720-0

    authors: Fischer A,Distler J

    更新日期:2019-10-01 00:00:00

  • Utility of age, gender, ANA titer and pattern as predictors of anti-ENA and -dsDNA antibodies.

    abstract::Monovariate and multivariate analyses including logistic regression were performed to determine associations among predicting variables [age, gender, immunofluorescence pattern, and anti-nuclear antibody (ANA) titer] and anti-extractable nuclear antigen (ENA) and -dsDNA antibodies (Abs) in 1089 patients with positive ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-004-0937-0

    authors: Kang I,Siperstein R,Quan T,Breitenstein ML

    更新日期:2004-12-01 00:00:00

  • Lymphoma developing in a patient with rheumatoid arthritis taking methotrexate.

    abstract::We report one case of non-Hodgkin lymphoma in a patient, with a 30-year history of rheumatoid arthritis, taking low dose methotrexate weekly over a 10-month period. The mild immunosuppression that occurs with methotrexate therapy probably places patients with rheumatoid arthritis at added risk of developing lymphoprol...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02231567

    authors: Taillan B,Garnier G,Castanet J,Ferrari E,Pesce A,Dujardin P

    更新日期:1993-03-01 00:00:00

  • Peripheral neuropathy, polymyalgia and arthralgia: a paraneoplastic syndrome associated with myeloma.

    abstract::We describe a patient with peripheral neuropathy, polymyalgia, arthralgia and cervical vertebral osteosclerosis who was subsequently diagnosed to have fatal multiple myeloma with IgG gammopathy and lambda urinary chains. The initial presentation and clinical features are discussed. ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02031978

    authors: Samanta A,Hilton D,Roy S

    更新日期:1990-06-01 00:00:00

  • Changes and clinical significance of CD8+CD122+ T cells in the peripheral blood of patients with ankylosing spondylitis.

    abstract::The aim of our study was to explore the relationship between circulating T cells and ankylosing spondylitis (AS) and to find the role of the CD8+CD122+ T cells in the pathogenesis and progression of AS. With the method of case-control design, flow cytometry was performed to quantitatively determine the percentage of c...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-017-3887-z

    authors: Han R,Yang X,Chen M,Zhang X,Yuan Y,Hu X,Wang M,Liu R,Ma Y,Yang J,Xu S,Shuai Z,Jiang S,Pan F

    更新日期:2018-03-01 00:00:00

  • A case of anti-Jo1 myositis with pleural effusions and pericardial tamponade developing after exposure to a fermented Kombucha beverage.

    abstract::The pathogenesis of the idiopathic inflammatory myopathies has been postulated to be an environmental trigger causing the expression of the disease in a genetically predisposed patient. We report a case of anti-Jo1 antibody-positive myositis which was associated with pleural effusions, pericardial effusion with tampon...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-004-0890-y

    authors: Derk CT,Sandorfi N,Curtis MT

    更新日期:2004-08-01 00:00:00

  • A retrospective analysis of distinguishing features of chest HRCT and clinical manifestation in primary Sjögren's syndrome-related interstitial lung disease in a Chinese population.

    abstract::To characterize the distinctive chest high-resolution computerized tomography (HRCT) features and clinical manifestations of primary Sjögren syndrome (pSS)-related interstitial lung disease (ILD). The demographic data, clinical manifestations, and laboratory and radiological findings of 527 pSS patients were retrospec...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-018-4289-6

    authors: Dong X,Zhou J,Guo X,Li Y,Xu Y,Fu Q,Lu Y,Zheng Y

    更新日期:2018-11-01 00:00:00

  • Successful treatment of hypertrophic pachymeningitis in refractory Wegener's granulomatosis with rituximab.

    abstract::Central nervous involvement (CNS) is uncommon manifestation of Wegener's granulomatosis (WG). We are describing a patient with refractory WG with CNS involvement which responded to rituximab. This lady presented with nodular scleritis. Three months later, she developed headache, vision loss with complete opthalmoplegi...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-009-1291-z

    authors: Sharma A,Kumar S,Wanchu A,Lal V,Singh R,Gupta V,Singh S,Gupta A

    更新日期:2010-01-01 00:00:00

  • Adult hypophosphatemic osteomalacia: report of two cases.

    abstract::Two cases of late hypophosphatemic osteomalacia are described: a male aged 30 who had the disease since he was 22 and a woman of 23 who had the disease since she was 14. Both presented with myopathy and bone pain, and showed hypophosphatemia, hyperglycinuria, reduced tubular phosphate reabsorption (TPR), increased hyd...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02031617

    authors: Rico H,Gomez-Castresana F,Hernandez ER,Matute JA,Torrubiano J,Nunez-Torrón M

    更新日期:1985-09-01 00:00:00

  • Pattern of systemic lupus erythematosus among Nigerians.

    abstract::Systemic lupus erythematosus (SLE) has rarely being reported among African Blacks, in contrast with African-Americans. Such reports have been mostly case reports. Our encounter with new cases shows that this disease may not be rare after all. The objective of this study was to study the clinical presentations, laborat...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-009-1139-6

    authors: Adelowo OO,Oguntona SA

    更新日期:2009-06-01 00:00:00

  • Discussing sexual concerns with chronic low back pain patients: barriers and patients' expectations.

    abstract::This study aims to explore patient's concerns when discussing sexual problems caused by chronic low back pain with their healthcare provider. It also aims to identify factors influencing and limiting such communication. A cross-sectional analysis of 100 consenting chronic low back pain sexually active patients was car...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-013-2299-y

    authors: Bahouq H,Allali F,Rkain H,Hajjaj-Hassouni N

    更新日期:2013-10-01 00:00:00

  • Subcutaneous sarcoidosis: report of two cases and review of the literature.

    abstract::Sarcoidosis is a multisystemic disease with cutaneous lesions present in about one fourth of patients. Cutaneous lesions may be specific or nonspecific based on the presence or the absence of sarcoidal granulomas. Subcutaneos sarcoidosis is the less frequent of the specific cutaneous lesions of sarcoidosis. We report ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/s10067-011-1731-4

    authors: Dalle Vedove C,Colato C,Girolomoni G

    更新日期:2011-08-01 00:00:00

  • Takayasu's arteritis-associated aneurysm formation without steno-occlusive lesions.

    abstract::The authors report a case of a 20-year-old woman with Takayasu's arteritis (TA) presenting with recurrent erythema nodosum-like lesions, elevated acute-phase proteins and aortographic findings of multiple aneurysmal dilatations of the aorta without the coexistence of steno-occlusive lesions. This finding indicates tha...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s100670050162

    authors: Boki KA,Pakas J,Kekatou K,Kataxaki E,Papapavlou E

    更新日期:2000-01-01 00:00:00

  • A comparison of diflunisal and phenylbutazone in the treatment of ankylosing spondylitis.

    abstract::A 12-week double-blind randomized drug trial followed by an open extension period of 36 weeks was carried out in 38 male patients with ankylosing spondylitis (AS) to compare the efficacy and safety of diflunisal (500 mg twice daily) and phenylbutazone (200 mg twice daily). Both drugs proved to be effective in improvin...

    journal_title:Clinical rheumatology

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1007/BF02032359

    authors: Franssen MJ,Gribnau FW,van de Putte LB

    更新日期:1986-06-01 00:00:00

  • Effect of corynebacterium parvum in the induction and course of mycoplasma arthritis of mice.

    abstract::The effect of the immunostimulant C. parvum on the establishment and course of mycoplasma arthritis of mice was investigated. Male Swiss albino mice were injected intra-venously with M. arthritidis culture and intraperitoneally with C. parvum. It was shown that mice immunostimulated with C. parvum were significantly p...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02032174

    authors: Kaklamani E,Kaklamanis P,Sparos L,Karalis D,Alikouli K,Koumandaki I,Trichopoulos D

    更新日期:1983-06-01 00:00:00

  • Normal serum concentrations of 1,25 dihydroxyvitamin D in osteoporosis.

    abstract::With the aim of evaluating the role of 1,25 dihydroxyvitamin D in the pathogenesis of osteoporosis, this hormone was studied in 90 subjects. They were divided into three groups: the first group consisted of 30 normal female subjects (aged 30 to 45); the second group comprised 30 elderly female subjects (aged 67 to 90)...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02031970

    authors: Cantatore FP,Carrozzo M

    更新日期:1990-06-01 00:00:00

  • Osteoporosis in rheumatoid arthritis: effect of disease activity.

    abstract::In addition to juxtaarticular osteoporosis, which appears to reflect predominantly local disease mechanisms, more generalized bone loss can occur in rheumatoid arthritis (RA). The aim of this study was to compare bone mineral density (BMD) of the lumbar spine and proximal femur in RA patients versus controls and evalu...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02207677

    authors: Celiker R,Gökçe-Kutsal Y,Cindas A,Ariyürek M,Renda N,Koray Z,Basgöze O

    更新日期:1995-07-01 00:00:00

  • Hyperimmunoglobulinemia D syndrome in an Arab child.

    abstract::Hyperimmunoglobulinemia D syndrome (HIDS) is newly recognized and resembles familial Mediterranean fever (FMF). It is inherited as an autosomal recessive trait. Mutation of the gene coding for mevalonate kinase is responsible for the disease. The gene is located at chromosome 12q24. The patients initially described we...

    journal_title:Clinical rheumatology

    pub_type: 信件

    doi:10.1007/s10067-004-0953-0

    authors: Hammoudeh M

    更新日期:2005-02-01 00:00:00

  • Interferon-gamma release assays in the detection of latent tuberculosis infection in patients with inflammatory arthritis scheduled for anti-tumour necrosis factor treatment.

    abstract::Biological agents, particularly anti-Tumour Necrosis Factor (TNF)-α agents, have emerged as an effective treatment in patients with chronic inflammatory diseases. An association between anti-TNF-α antibodies and reactivation of latent tuberculosis infection (LTBI) has been established. Appropriate screening for TB inf...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-012-1938-z

    authors: Mínguez S,Latorre I,Mateo L,Lacoma A,Diaz J,Olivé A,Domínguez J

    更新日期:2012-05-01 00:00:00

  • Quality of life in patients with Takayasu's arteritis is impaired and comparable with rheumatoid arthritis and ankylosing spondylitis patients.

    abstract::The aims of the study were to assess the health-related quality of life (QOL) in patients with Takayasu's arteritis (TA) by two different generic QOL instruments and to compare the results with those patients with rheumatoid arthritis (RA), ankylosing spondylitis (AS), and healthy controls (HC). A cross-sectional stud...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-007-0813-9

    authors: Akar S,Can G,Binicier O,Aksu K,Akinci B,Solmaz D,Birlik M,Keser G,Akkoc N,Onen F

    更新日期:2008-07-01 00:00:00

  • Association of tumor necrosis factor-α (G-308A) genetic variant with matrix metalloproteinase-9 activity and joint destruction in early rheumatoid arthritis.

    abstract::Matrix metalloproteinases (MMPs) are the key enzymes responsible for the joint destruction. Their activity is regulated by the level of proinflammatory cytokines. The aim of this study was to examine the impact of TNF-α G-308A polymorphism on MMP-9 levels in blood plasma (BP) and synovial fluid (SF) of patients with r...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-017-3699-1

    authors: Stojanovic S,Bojana Stamenkovic,Stoimenov TJ,Nedovic J,Zivkovic V,Despotovic M,Pavlovic D

    更新日期:2017-07-01 00:00:00

  • Cost of medication errors in rheumatic patients in Mexico.

    abstract::This study aims to measure the frequency of medication error (ME) in rheumatology outpatients of the Social Security System (SS) in Mexico and to measure the costs by comparing the days lost at work as direct consequence of the medication error against the theoretical cost of no error in the process. A prospective 6-m...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-011-1837-8

    authors: Aceves-Avila FJ,Benites-Godínez V,Ramos-Remus C

    更新日期:2011-11-01 00:00:00

  • Intracellular signal transduction in proliferation of synovial cells.

    abstract::We investigated some steps in the signal transduction pathway leading to the proliferation of synovial cells. 12-o-tetradecanoyl phorbol-13-acetate (TPA) which is known to stimulate phospholipid- and Ca(2+)-dependent protein kinase (C-kinase) enhanced the proliferation of synovial cells. The proliferation of synovial ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02207092

    authors: Yamamoto M,Yasuda M,Shiokawa S,Nobunaga M

    更新日期:1992-03-01 00:00:00

  • Reiter's syndrome--a comparative study of patients with the complete and the incomplete syndrome.

    abstract::Eighty patients with Reiter's syndrome (RS) were studied retrospectively. A comparison was made between patients with the complete syndrome and patients with the incomplete syndrome. A comparison was also made between patients with and without HLA-B27. There were no major differences in severity and duration of the ar...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/BF02030971

    authors: Bengtsson A,Lindström FD,Lindblom B

    更新日期:1986-01-01 00:00:00

  • Serum levels of the bone turnover markers dickkopf-1, osteoprotegerin, and TNF-α in knee osteoarthritis patients.

    abstract::Knee osteoarthritis (KOA) is a common degenerative joint disease causing pain, stiffness, reduced motion, swelling, crepitus, and disability. Several inflammatory markers and cartilage degradation products can be used as biomarkers in OA. The key factors of bone metabolism in normal joint bone, dickkopf-1 (DKK1) and o...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-017-3690-x

    authors: Min S,Wang C,Lu W,Xu Z,Shi D,Chen D,Teng H,Jiang Q

    更新日期:2017-10-01 00:00:00

  • Multiple avascular necrosis in a patient with systemic lupus erythematosus/systemic sclerosis overlap syndrome.

    abstract::A white female patient developed overlapping features of systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) with severe pulmonary compromise. She was treated with steroids and azathioprine, which improved her clinical condition and spirometric status. In May 2002 she presented with continuous pain in her ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-004-1048-7

    authors: Cavallasca JA,Laborde HA,Araujo MB,Nasswetter GG

    更新日期:2005-08-01 00:00:00

  • Risedronate-associated scleritis: a case report and review of the literature.

    abstract::This paper presents the first reported case of risedronate-associated scleritis and conducts a review of bisphosphonates and inflammatory eye diseases. A case of scleritis associated with risedronate use in a 73-year-old Chinese woman is reported. The English medical literature was reviewed for bisphosphonates and the...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章,评审

    doi:10.1007/s10067-012-2035-z

    authors: Hemmati I,Wade J,Kelsall J

    更新日期:2012-09-01 00:00:00

  • Efficacy of febuxostat versus allopurinol and the predictors of achieving target serum urate in a cohort of Thai people with gout.

    abstract:OBJECTIVE:The objectives of our study were to compare the efficacy of febuxostat with allopurinol in Thai subjects with gout, as well as to determine the predictive factors of responsiveness to urate-lowering agents and to evaluate the safety of febuxostat in a real-world setting. METHODS:The study was a retrospective...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-020-05262-6

    authors: Lertnawapan R,Jatuworapruk K

    更新日期:2021-01-01 00:00:00

  • Serum adropin level and ENHO gene expression in systemic sclerosis.

    abstract::Adropin, a secreted protein, is encoded by the energy homeostasis associated (ENHO) gene. It has been implicated in the several physiological and pathological processes such as angiogenesis and apoptosis. Therefore, the aim of present study was to investigate serum adropin levels and ENHO gene expressions in systemic ...

    journal_title:Clinical rheumatology

    pub_type: 杂志文章

    doi:10.1007/s10067-016-3266-1

    authors: Yolbas S,Kara M,Yilmaz M,Aydin S,Koca SS

    更新日期:2016-06-01 00:00:00