Abstract | BACKGROUND: METHODS AND RESULTS: We describe two patients with Chagas' disease who underwent heart transplantation. The first one had asthenia, anorexia, and several painful subcutaneous nodules in the legs after transplantation; biopsy showed an inflammatory infiltrate with intracytoplasmatic nests of Trypanosoma cruzi, confirmed by immunohistochemical stains with monoclonal antibodies specific to parasitic antigens. Allopurinol (600 mg/day) produced complete regression of the symptoms and the nodules with a negative control biopsy within 2 weeks. Treatment was maintained for 2 months. Mild leukopenia developed which improved after azathioprine reduction, and no further side-effects were noted. The second patient had sudden heart failure months after transplantation; endomyocardial biopsy showed myocardial fibers infested with Trypanosoma, and a concomitantly performed right heart catheterization showed a low cardiac index and highfilling pressures. The patient received allopurinol at a daily dose of 900 mg and conventional treatment for heart failure. Echocardiogram showed improved wall motion and decreased left ventricular dimensions, and control biopsy showed no inflammatory activity; cardiac index and filling pressures normalized. Treatment was maintained for 2 months without side effects. The two patients have not had recurrences and were in New York Heart Association functional class I 12 and 3 months, respectively, after discontinuation of allopurinol. CONCLUSIONS:
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Authors | D R Almeida, A C Carvalho, J N Branco, A P Pereira, L Correa, P V Vianna, E Buffolo, E E Martinez |
Journal | The Journal of heart and lung transplantation : the official publication of the International Society for Heart Transplantation
(J Heart Lung Transplant)
Vol. 15
Issue 10
Pg. 988-92
(Oct 1996)
ISSN: 1053-2498 [Print] United States |
PMID | 8913915
(Publication Type: Case Reports, Journal Article)
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Chemical References |
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Topics |
- Adult
- Allopurinol
(therapeutic use)
- Chagas Cardiomyopathy
(drug therapy, surgery)
- Chagas Disease
(drug therapy)
- Heart Failure
(parasitology, surgery)
- Humans
- Immunosuppression Therapy
- Male
- Middle Aged
- Recurrence
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