城市人群中的先天性恰加斯病：对感染双胞胎的调查。

Congenital Chagas's disease in an urban population: investigation of infected twins.

作者信息

Hoff R, Mott K E, Milanesi M L, Bittencourt A L, Barbosa H S

出版信息

Trans R Soc Trop Med Hyg. 1978;72(3):247-50. doi: 10.1016/0035-9203(78)90203-1.

Abstract

In the Nordeste de Amaralina suburb of Salvador Bahia, Brazil, 47 of 285 pregnant women surveyed had complement fixing antibodies to Trypanosoma cruzi. At delivery T. cruzi was detected in one of 17 placentas from the sero-positive women. The offspring of this case were premature twins and T. cruzi was detected in the peripheral blood of each before death. At autopsy the gastro-intestinal tract and urinary bladder of both were severely affected. Immunofluorescence tests on cord sera, including the single case with T. cruzi in the placenta, were negative for IgM antibodies to T. cruzi. The mother of the infected twins and three of her living children, who were born and have resided in the city, were also infected with T. cruzi. Although the children had visited an area endemic for Chagas's disease for short periods, the mode of transmission in this family may have been transplacental. The value of the immunofluorescence test in the diagnosis of congenital Chagas's disease is discussed.

摘要

在巴西巴伊亚州萨尔瓦多市阿马拉利纳郊区的东北部，接受调查的285名孕妇中有47人具有针对克氏锥虫的补体结合抗体。分娩时，在17名血清阳性妇女的胎盘中有1个检测到克氏锥虫。该病例的后代是早产双胞胎，在死亡前两人的外周血中均检测到克氏锥虫。尸检时，两人的胃肠道和膀胱均受到严重影响。对脐带血清进行的免疫荧光检测，包括胎盘中有克氏锥虫的单个病例，针对克氏锥虫的IgM抗体检测均为阴性。受感染双胞胎的母亲及其三个在该市出生并居住的在世子女也感染了克氏锥虫。尽管这些孩子曾短期前往恰加斯病流行地区，但该家庭的传播方式可能是经胎盘传播。文中讨论了免疫荧光检测在先天性恰加斯病诊断中的价值。