A patient with a rheumatologic disorder may suffer a reactivation of Chagas disease after receiving immunosuppressive therapy. The reactivated Chagas disease may mimic relapse of the rheumatologic disorder. The authors are from National University of Rosario in Argentina.
Patient selection: rheumatologic patient with a history of Chagas disease
Risk factors for reactivation:
(1) >= 20 mg per day or prednisone equivalent
(2) other immunosuppressive therapy
Clinical signs and symptoms may include:
(1) fever
(2) asthenia
(3) myalgias
(4) arthralgias
Laboratory findings:
(1) increased titer of specific anti-T. cruzi antibodies
(2) increased titer of anti-SAPA antibodies (to acute phase antigen)
(3) positive PCR
The antibody titers decrease after anti-parasitic therapy.
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