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未定带虫期的恰加斯病:历史、概念、临床和预后方面。

Indeterminate form of Chagas disease: historical, conceptual, clinical, and prognostic aspects.

机构信息

Fundação Oswaldo Cruz, Instituto Nacional de Infectologia Evandro Chagas, Rio de Janeiro, RJ, Brasil.

Universidade Federal do Rio de Janeiro, Faculdade de Medicina, Rio de Janeiro, RJ, Brasil.

出版信息

Rev Soc Bras Med Trop. 2021 Jul 23;54:e02542021. doi: 10.1590/0037-8682-0254-2021. eCollection 2021.

Abstract

Chagas disease (CD) remains a serious endemic disease in Latin America and a major public health problem. Because of globalization, the disease has spread to non-endemic areas in the northern hemisphere. In the chronic phase of the disease, most patients present with the indeterminate form (IF), characterized by positive serology for Trypanosoma cruzi, absence of clinical findings, and normal findings in electrocardiogram (ECG). IF was not recognized as a clinical entity until decades after the discovery of the disease, and only in the 1940-50s, it was categorized as a form of CD, and its conceptual definition was ratified in the 1980s. Children, adolescents, and young adults with the IF benefit from etiological treatment and tend to have less progression to heart disease in the long term than the untreated ones. IF patients have an essentially benign clinical condition, and their prognosis can be compared to that of healthy individuals with normal ECG findings. Currently, because of aging, patients with the IF have comorbidities that require attention in health services.

摘要

恰加斯病(CD)仍然是拉丁美洲的一种严重地方病,也是一个主要的公共卫生问题。由于全球化,该疾病已传播到北半球的非流行地区。在疾病的慢性期,大多数患者表现为不确定型(IF),其特征是对克氏锥虫呈阳性血清学反应,无临床发现,心电图(ECG)正常。IF 直到疾病发现几十年后才被认为是一种临床实体,直到 20 世纪 40 年代至 50 年代,它才被归类为 CD 的一种形式,其概念定义在 20 世纪 80 年代得到批准。患有 IF 的儿童、青少年和年轻人受益于病因治疗,并且与未经治疗的患者相比,长期患心脏病的进展较少。IF 患者的临床状况基本良好,其预后可与心电图正常的健康个体相媲美。目前,由于老龄化,IF 患者存在需要在卫生服务中注意的合并症。

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