MEM INST OSWALDO CRUZ, RIO DE JANEIRO, Vol. 112 | 2017
PAGES: DOI: 10.1590/0074-02760170383 Full paper
Chagas disease and systemic autoimmune diseases among Bolivian patients in Switzerland

Yves Jackson1,2,+, Drenusha Vieira de Mello Pula1, Axel Finckh3, Carlo Chizzolini4, François Chappuis5

1Geneva University Hospitals and University of Geneva, Division of Primary Care Medicine, Geneva, Switzerland
2University of Geneva, Institute of Global Health, Geneva, Switzerland
3Geneva University Hospitals and University of Geneva, Division of Rheumatology, Geneva, Switzerland
4Geneva University Hospitals and University of Geneva, Division of Immunology, Geneva, Switzerland
5Geneva University Hospitals and University of Geneva, Division of Tropical and Humanitarian Medicine, Geneva, Switzerland

Abstract

BACKGROUND Chronic cardiomyopathy occurs in 20-40% of the patients with Chagas disease. Autoimmune mechanisms may contribute to its pathogenesis. We diagnosed several cases of systemic autoimmune diseases among Bolivian migrants in Geneva with a high prevalence of Chagas disease.

OBJECTIVES We tested the hypothesis of a clinical association between systemic autoimmune diseases and Chagas disease, particularly with the development of cardiomyopathy.

METHODS We retrospectively searched the medical records of all Bolivian patients visiting Geneva University Hospitals between 2012 and 2015 for diagnosis of Chagas disease or systemic autoimmune diseases.

FINDINGS Of the 2,189 eligible patients, 28 [1.3%; 95% confidence interval (CI) = 0.9-1.9%] presented with systemic autoimmune disease. The Chagas status was known in 903 (41.3%) patient, of whom 244 (27.0%; 95% CI = 24.2-30.0%) were positive. Eight (28.6%; 95% CI = 15.3-47.1%) of the 28 cases of systemic autoimmune disease had Chagas disease. We found no association between both entities (p = 1.000) or with Chagasic cardiomyopathy (p = 0.729). Moreover, there was no evidence of a temporal relationship between antiparasitic chemotherapy and the development of systemic autoimmune diseases.

CONCLUSIONS Our results do not support a clinical association between chronic Chagas disease and systemic autoimmune diseases. However, prospective studies in areas endemic for Chagas disease should better assess the prevalence of systemic autoimmune diseases and thus a possible relationship with this infection.

+ Corresponding author: This e-mail address is being protected from spambots. You need JavaScript enabled to view it.
Received 22 September 2017
Accepted 7 December 2017

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