| Abstract | BACKGROUND: Chagas' disease is endemic in many Latin American countries. In the last decades, millions of people from these countries have migrated to the United States, changing the scenario of acute Chagas' disease associated with blood transfusion in North America. METHODS AND RESULTS: We report the case of a chagasic patient who developed intracranial hypertension and focal neurologic signs 7 months after heart transplantation. Immunosuppression after transplantation was achieved with prednisone, cyclosporine A, and mycophenolate mofetil. Cranial magnetic resonance imaging revealed a right temporoparietal mass lesion with surrounding edema. Trypanosoma cruzi was observed in the cerebrospinal fluid by Giemsa method, and autopsy disclosed a cerebral chagoma with amastigote forms of T cruzi, with neither associated myocarditis nor systemic infection. CONCLUSION: In chagasic patients who undergo heart transplantation and immunosuppression, the risk of late reactivation of Chagas' disease by means of an isolated cerebral mass lesion must be considered. |
| Authors | Paulo Euripedes Marchiori, Paula Levatti Alexandre, Nise Britto, Roseli A Patzina, A Alfredo Fiorelli, Leandro T Lucato, Sergio Rosemberg, Samira L Apostolos Pereira, Noedir Groppo Stolf, Milberto Scaff
(Affiliation: Department of Neurology, São Paulo University School of Medicine, São Paulo, Brazil. bibliotecaneuro at hcnet.usp.br)
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| Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 26
Issue 11
Pg. 1091-6
(Nov 2007)
ISSN: 1557-3117 United States |
| PMID | 18022073
(Publication Type: Case Reports, Journal Article)
|
| Topics |
- Animals
- Brain
(parasitology, pathology)
- Chagas Cardiomyopathy
(surgery)
- Chagas Disease
(complications, diagnosis)
- Encephalitis
(diagnosis, etiology)
- Heart Transplantation
(adverse effects)
- Humans
- Immunosuppression
(methods)
- Magnetic Resonance Imaging
- Male
- Middle Aged
- Recurrence
- Trypanosoma cruzi
(pathogenicity)
|
