Genetic Susceptibility to Cardiac and Digestive Clinical Forms of Chronic Chagas Disease: Involvement of the CCR5 59029 A/G Polymorphism.

The clinical manifestations of chronic Chagas disease include the cardiac form of the disease and the digestive form. Not all the factors that act in the variable clinical course of this disease are known. This study investigated whether the CCR5Δ32 (rs333) and CCR5 59029 A/G (promoter region--rs1799987) polymorphisms of the CCR5 gene are associated with different clinical forms of chronic Chagas disease and with the severity of left ventricular systolic dysfunction in patients with chronic Chagas heart disease (CCHD). The antibodies anti-T. cruzi were identified by ELISA. PCR and PCR-RFLP were used to identify the CCR5Δ32 and CCR5 59029 A/G polymorphisms. The chi-square test was used to compare variables between groups. There was a higher frequency of the AA genotype in patients with CCHD compared with patients with the digestive form of the disease and the control group. The results also showed a high frequency of the AG genotype in patients with the digestive form of the disease compared to the other groups. The results of this study show that the CCR5Δ32 polymorphism does not seem to influence the different clinical manifestations of Chagas disease but there is involvement of the CCR5 59029 A/G polymorphism in susceptibility to the different forms of chronic Chagas disease. Besides, these polymorphisms do not influence left ventricular systolic dysfunction in patients with CCHD

Intestinal obstruction caused by phytobezoar composed of jaboticaba seeds: case report and literature review

Bezoar is a cluster of swallowed and undigested material in the gastrointestinal tract which can cause intestinal obstruction. It has multiple subtypes and the phytobezoar (composed of vegetable fiber) is the most common. We report a patient admitted with intestinal obstruction caused by impaction of multiples seeds of jaboticaba in the rectum. The treatment included multiple enemas, laxatives and digital maneuvers and it was effective after four days. Only one similar report was found in the literature.<br>Bezoar trata-se de um aglomerado de material deglutido e não digerido no trato gastrointestinal que pode causar quadro de obstrução intestinal. Existem múltiplos subtipos, sendo o mais comum o fitobezoar (composto por fibras vegetais). Foi relatado o caso de uma paciente admitida com quadro de suboclusão intestinal causada por impactação de múltiplos caroços de jabuticaba em reto. O tratamento instituído foi conservador com múltiplos enteroclimas, laxativos e quebra digital, efetivos após quatro dias. Somente um caso semelhante foi encontrado na literatura

Frequency of genotypes and alleles of the <i>CCR5</i>Δ32 polymorphism in patients with chronic Chagas disease and control subjects.

<p>^a DF: Degrees of freedom</p><p>^b Calculated by χ².</p><p>Frequency of genotypes and alleles of the <i>CCR5</i>Δ32 polymorphism in patients with chronic Chagas disease and control subjects.</p

<i>CCR5</i> 59029 A/G polymorphism analysis using the recessive inheritance model.

<p>^a DF: Degrees of freedom</p><p>^b Calculated by χ².</p><p><i>CCR5</i> 59029 A/G polymorphism analysis using the recessive inheritance model.</p

<i>CCR5</i> 59029 A/G polymorphism analysis using the dominant inheritance model.

<p>^a DF: Degrees of freedom</p><p>^b Calculated by χ².</p><p><i>CCR5</i> 59029 A/G polymorphism analysis using the dominant inheritance model.</p

Frequency of genotypes and alleles of the <i>CCR5</i> 59029 A/G polymorphism in patients with Chagas disease and control subjects

<p>^a DF: Degrees of freedom</p><p>^b Calculated by χ².</p><p>Frequency of genotypes and alleles of the <i>CCR5</i> 59029 A/G polymorphism in patients with Chagas disease and control subjects</p

Frequency of genotypes and alleles of the <i>CCR5</i> 59029 A/G polymorphism in patients with chronic Chagas heart disease with normal left ventricular systolic function, mild to moderate, and severe left ventricular systolic dysfunction.

<p>LVSD: Left ventricular systolic dysfunction</p><p>^a DF: Degrees of freedom</p><p>^b Calculated by χ².</p><p>Frequency of genotypes and alleles of the <i>CCR5</i> 59029 A/G polymorphism in patients with chronic Chagas heart disease with normal left ventricular systolic function, mild to moderate, and severe left ventricular systolic dysfunction.</p