RESUMO
Benznidazole is recommended in Brazil for the treatment of Trypanosoma cruzi infection in acute and early chronic phases of Chagas' disease. Observations by others have indicated a higher incidence of neoplasias in immunosuppressed patients, presenting Chagas' disease reactivation, submitted to treatment with benznidazole. In the present study, we investigated whether there is a potentiation in the generation of lymphomas in chronically infected mice, treated with immunosuppressive drugs and benznidazole. For this, 142 Swiss mice chronically infected with the 21 SF strain of T. cruzi and 72 normal Swiss mice were used. Both infected and normal mice were divided into experimental groups and submitted to one of the following treatment regimens: benznidazole alone; immunosuppressive drugs (azathioprine, betamethasone and cyclosporin); a combination of immunosuppressive drugs and benznidazole; and untreated controls. In the infected group treated with benznidazole, one mouse developed a non-Hodgkin's lymphoma. This finding has been interpreted as a spontaneous tumor of mice. The study of the chronically infected mice treated with the combination of immunosuppressive drugs and benznidazole demonstrated an absence of lymphomas or other neoplasias. These findings support the indication of benznidazole, as the drug of choice, for immunosuppressed patients that develop a reactivation of Chagas' disease.
Assuntos
Doença de Chagas/tratamento farmacológico , Imunossupressores/efeitos adversos , Neoplasias/induzido quimicamente , Nitroimidazóis/efeitos adversos , Tripanossomicidas/efeitos adversos , Animais , Azatioprina/efeitos adversos , Azatioprina/uso terapêutico , Betametasona/efeitos adversos , Betametasona/uso terapêutico , Doença de Chagas/patologia , Doença Crônica , Ciclosporina/efeitos adversos , Ciclosporina/uso terapêutico , Modelos Animais de Doenças , Combinação de Medicamentos , Imunossupressores/uso terapêutico , Contagem de Leucócitos , Camundongos , Nitroimidazóis/uso terapêutico , Tripanossomicidas/uso terapêuticoRESUMO
The differential diagnosis of chronic diarrhea is extensive and requires the investigation of several diseases, such as celiac disease, inflammatory bowel disease and irritable bowel syndrome. A few patients infected by Trichuris trichiura may present a chronic dysentery-like syndrome in the context of a massive infestation of the colon leading to anemia and growth retardation, but the rarity of that finding demands a high level of suspicion. Herein we report the case of an 8-year-old boy from the rural zone who had suffered diarrhea without blood or mucus for 4 years and was taken to our Service because his mother had noticed the presence of blood on the feces on the 3 previous months. The diagnosis of a massive Trichuris trichiura infestation as the cause of the process was only reached by colonoscopy. We stress that Trichuris trichiura infection can mimic other forms of inflammatory bowel disease and lead to physical growth retardation and that prolonged regimens of albendazole may be required to the effective treatment of massive infestations.
Assuntos
Disenteria Amebiana/etiologia , Tricuríase/complicações , Trichuris/isolamento & purificação , Animais , Brasil , Criança , Doença Crônica , Colonoscopia , Disenteria Amebiana/diagnóstico , Disenteria Amebiana/terapia , Humanos , Masculino , Prognóstico , Medição de Risco , Índice de Gravidade de Doença , Tricuríase/diagnósticoRESUMO
Benznidazole is recommended in Brazil for the treatment of Trypanosoma cruzi infection in acute and early chronic phases of Chagas' disease. Observations by others have indicated a higher incidence of neoplasias in immunosuppressed patients, presenting Chagas' disease reactivation, submitted to treatment with benznidazole. In the present study, we investigated whether there is a potentiation in the generation of lymphomas in chronically infected mice, treated with immunosuppressive drugs and benznidazole. For this, 142 Swiss mice chronically infected with the 21 SF strain of T. cruzi and 72 normal Swiss mice were used. Both infected and normal mice were divided into experimental groups and submitted to one of the following treatment regimens: benznidazole alone; immunosuppressive drugs (azathioprine, betamethasone and cyclosporin); a combination of immunosuppressive drugs and benznidazole; and untreated controls. In the infected group treated with benznidazole, one mouse developed a non-Hodgkin's lymphoma. This finding has been interpreted as a spontaneous tumor of mice. The study of the chronically infected mice treated with the combination of immunosuppressive drugs and benznidazole demonstrated an absence of lymphomas or other neoplasias. These findings support the indication of benznidazole, as the drug of choice, for immunosuppressed patients that develop a reactivation of Chagas' disease
Assuntos
Animais , Camundongos , Doença de Chagas , Imunossupressores , Neoplasias , Tripanossomicidas , Azatioprina , Betametasona , Doença de Chagas , Doença Crônica , Ciclosporina , Modelos Animais de Doenças , Combinação de Medicamentos , Imunossupressores , Contagem de Leucócitos , TripanossomicidasRESUMO
Apresenta-se uma técnica cirúrgica de neurólise externa do nervo ulnar com o uso de anestesia local e sem isquemia peroperatória. Crê-se que este procedimento representa boa opçäo de uso no tratamento ambulatorial em longa escala da neuropatia do nervo ulnar, especialmente em pacientes com hanseníase.