title: Clinical forms of Trypanosoma cruzi infected individuals in the chronic phase of Chagas disease in Puebla, Mexico.
abstract: In Mexico, despite the relatively high seroprevalence of Trypanosoma cruzi infection in humans in some areas, reported morbidity of Chagas disease is not clear. We determined clinical stage in 71 individuals seropositive to T. cruzi in the state of Puebla, Mexico, an area endemic for Chagas disease with a reported seroprevalence of 7.7%. Diagnosis of Chagas disease was made by two standardized serological tests (ELISA, IHA). Individuals were stratified according to clinical studies. All patients were submitted to EKG, barium swallow, and barium enema. Groups were identified as indeterminate form (IF) asymptomatic individuals without evidence of abnormalities (n = 34 cases); those with gastrointestinal alterations (12 patients) including symptoms of abnormal relaxation of the lower esophageal sphincter and absent peristalsis in the esophageal body, grade I megaesophagus, and/or megacolon; patients with clinical manifestations and documented changes of chronic Chagas heart disease who were subdivided as follows: mild (8 patients)--mild electrocardiographic changes of ventricular repolarization, sinus bradychardia); moderate (6 patients)--left bundle branch block, right bundle branch block associated with left anterior fascicular block); severe (8 patients)--signs of cardiomegaly, dilated cardiomyopathy); and the associated form (3 cases) that included presence of both cardiomyopathy and megaesophagus. These data highlight the importance of accurate evaluation of the prevalence and clinical course of Chagas disease in endemic and non-endemic areas of Mexico.
authors.affiliation: Laboratorio de Investigación en Fisiopatología de Enfermedades Cróncas, Centro de Investigación Biomédica de Oriente, IMSS, Puebla, México.
authors.forename: María Del Carmen
authors.initials: Mdel C
authors.lastname: Sánchez-Guillén
authors.forename: Aurelio
authors.initials: A
authors.lastname: López-Colombo
authors.forename: Guillermo
authors.initials: G
authors.lastname: Ordóñez-Toquero
authors.forename: Isidoro
authors.initials: I
authors.lastname: Gomez-Albino
authors.forename: Judith
authors.initials: J
authors.lastname: Ramos-Jimenez
authors.forename: Enrique
authors.initials: E
authors.lastname: Torres-Rasgado
authors.forename: Hilda
authors.initials: H
authors.lastname: Salgado-Rosas
authors.forename: Mónica
authors.initials: M
authors.lastname: Romero-Díaz
authors.forename: Patricia
authors.initials: P
authors.lastname: Pulido-Pérez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Pérez-Fuentes
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood*; D000953:Antigens, Protozoan; D014355:Chagas Disease / Q000145:classification* / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002908:Chronic Disease; D019353:Endemic Diseases; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006385:Hemagglutination Inhibition Tests; D006801:Humans; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D012720:Severity of Illness Index; D014349:Trypanosoma cruzi / Q000276:immunology*; D020525:Xenodiagnosis
chemical_list: D000913:Antibodies, Protozoan; D000953:Antigens, Protozoan