Kidney Involvement in Chagas’ Disease (American Trypanosomiasis)
摘要
Chagas disease is a parasitic disease caused by the flagellated protozoan Trypanosoma cruzi, and its vectors are insects of the Triatomidae family, Triatoma infestans. The disease is endemic in Latin America and is characterized by the involvement of the parasympathetic nervous system and, to a lesser extent, of the sympathetic nervous system, due to neuronal destruction associated with inflammation and the immune process caused directly or indirectly by T. cruzi. In the chronic phase of the disease, the indeterminate, cardiac or gastrointestinal forms may occur. Kidney involvement is uncommon, with few studies on the subject being found in the literature. Acute kidney injury occurs around the sixth day of acute infection and is related to cardiovascular dysfunction, due to a transient decrease in kidney blood flow. Glomerulonephritis is described in the chronic phase of the disease, with glomerular deposition of IgM and an intense inflammatory response promoting the formation of immune complexes. The specific treatment is carried out with benznidazole, which is the drug of choice.