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Basement membrane thickening in cardiac myocytes and capillaries in chronic Chagas' disease

1988; Elsevier BV; Volume: 61; Issue: 13 Linguagem: Inglês

10.1016/0002-9149(88)90148-8

1879-1913

Victor J. Ferrans, José Milei, Yoshifumi Tomita, Rubén Storino,

Eosinophilic Disorders and Syndromes

Chronic cardiomyopathy is the most serious and most common manifestation of the chronic form of Chagas' disease and constitutes the most common type of chronic myocarditis in the world. The initial parasitic infestation characterizing the acute phase of Chagas' disease, its remission and subsequent development and progression of the chronic phase are well documented. Little is known of the pathogenesis of the chronic phase of Chagas' disease, in which there is a low level of parasitemia and/or of persistence of the parasites in tissues, and lymphocytic infiltrates and extensive areas of fibrosis are the usual myocardial histologic findings. These facts support the hypothesis that the chronic phase of Chagas' disease is mediated, at least in part, by immune phenomena rather than by continuing parasitic invasion of the heart or local release of parasite toxins.1 Immunohistochemical studies of chronic Chagas' disease have demonstrated deposits of immunoglobulins in the interestitium and on the external surfaces of myocytes and capillaries of the heart.2 However, only nonspecific changes of myocyte hypertrophy and degeneration and interstitial fibrosis have been observed in ultrastructural studies of chronic Chagas' disease in human patients3–6 and experimental animals.7,8 Therefore, the present study was undertaken to evaluate the external surfaces of cardiac myocytes and capillaries in chronic Chagas' disease.