The laboratory in different stages of chagas disease

Around 20 to 30% of Chagas infected people will suffer from cardiac problems. The aim of this work was to evaluate if C Reactive Protein (CRP), parasitemia and/or high titters of specific antibodies could predict risk of cardiac disease. The study was performed in two Capital Federal centers: Hospital de Clinicas'Jose de San Martin' and Hospital'Jose Maria Penna'. 100 patients were selected, 70 of them were in the chronic stage of the disease, with more than 15 years of evolution and were positive for two or three serological Chagas techniques. The patients were divided into three groups, a) Group I: 40 patients in the indeterminate stage (asymptomatic), b) Group II: 21 patients with cardiopathy A (arrhythmias and/or conduction disorders), c) Group III: 9 patients with cardiopathy B (cardiomegaly and congestive insufficiency). 65% of patients in Group I presented high titters of indirect hemaglutination (>1/256). This result reveals the necessity of performing a prospective study to evaluate whether this finding is related to the onset of cardiac symptoms or not. Even though cardiac damage could be explained as an inflammatory process where cardiac mononuclear cells are infiltrated by parasites (probable effectors of tissue damage), there was no correlation found between cardiac alteration and serum levels of CRP, parasitemia or high levels of specific antibodies.