The indeterminate form of human chronic Chagas' disease: a clinical epidemological review

• Main Author: João Carlos Pinto Dias
• Format: Article in Journal/Newspaper
• Language: English
• Published: Sociedade Brasileira de Medicina Tropical (SBMT) 1989
• Subjects: Doença de Chagas; Forma indeterminada; Prognóstico; Fatores de evolução; Chagas' disease; Indeterminante form; Prognosis; Evolution factors; Arctic medicine. Tropical medicine; RC955-962; Arctic; Prisma; Sob’
• Online Access: https://doaj.org/article/98e98e62b71749c4ba7a482359008eba

Data on the epidemiology and the natural history of the indeterminate form of human chronic Chagas' disease (IFCCD) are discussed, revealing its great importance in endemic areas of Brazil. The work shows that IFCCD presents a gradual and very slow course, causing a benign picture in the studied patients. Evolution patterns, prognostic and anatomopathological features are also discussed. For practical purposes, the classical concept of IFCCD proved to be simple, operational and consistent, It is defined by the absence of symptoms and clinical findings in chronic infected patients with positive serology and/or parasitological examinations for Trypanosoma cruzi coupled with normal electrocardiographic and radiological exams (heart, oesophagus and colon X-Rays). If a patient is submitted to more rigorous and sophisticated tests, these can reveal some alterations, generally small ones and unable to interfere with the prognosis of the infection. It is suggested that research lines specially related to the evolution ary factors and immunological involvement during this phase be adopted. Analisam-se epidemiologia e a história natural da forma indeterminada da doença de Chagas (FCI), confirmando-se sua grande importância epidemiológica em áreas endêmicas da tripanosomose, no Brasil. Os dados mostram que a evolução da FCI é geralmente lenta, com bom prognóstico, discutindo-se alguns fatores evolutivos, o prognóstico e o substrato anatomopatológico desta entidade. Sob o prisma prático, verifica-se que o conceito clássico da FCI se mostra simples, consistente e operacional: define-se no paciente crônico e assintomático, portador de provas sorológicas e/ou parasitológicaspositivas para T. cruzi, com exames clínico, eletrocardiográfico e radiológico (área cardíaca, esófago e cólon) normais. Exames outros mais rigorosos e sofisticados podem demonstrar algumas alterações e anormalidades nestes pacientes, geralmente discretas e pouco interferentes no prognóstico. Fazem-se algumas sugestões de pesquisa sobre a FCI, ...