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. 2018 Feb 5;113(4):e170383.
doi: 10.1590/0074-02760170383.

Chagas disease and systemic autoimmune diseases among Bolivian patients in Switzerland

Yves Jackson  1   2 , Drenusha Vieira de Mello Pula  1 , Axel Finckh  3 , Carlo Chizzolini  4 , François Chappuis  5
Affiliations

Chagas disease and systemic autoimmune diseases among Bolivian patients in Switzerland

Yves Jackson et al. Mem Inst Oswaldo Cruz. .

Abstract

Background: Chronic cardiomyopathy occurs in 20-40% of the patients with Chagas disease. Autoimmune mechanisms may contribute to its pathogenesis. We diagnosed several cases of systemic autoimmune diseases among Bolivian migrants in Geneva with a high prevalence of Chagas disease.

Objectives: We tested the hypothesis of a clinical association between systemic autoimmune diseases and Chagas disease, particularly with the development of cardiomyopathy.

Methods: We retrospectively searched the medical records of all Bolivian patients visiting Geneva University Hospitals between 2012 and 2015 for diagnosis of Chagas disease or systemic autoimmune diseases.

Findings: Of the 2,189 eligible patients, 28 [1.3%; 95% confidence interval (CI) = 0.9-1.9%] presented with systemic autoimmune disease. The Chagas status was known in 903 (41.3%) patient, of whom 244 (27.0%; 95% CI = 24.2-30.0%) were positive. Eight (28.6%; 95% CI = 15.3-47.1%) of the 28 cases of systemic autoimmune disease had Chagas disease. We found no association between both entities (p = 1.000) or with Chagasic cardiomyopathy (p = 0.729). Moreover, there was no evidence of a temporal relationship between antiparasitic chemotherapy and the development of systemic autoimmune diseases.

Conclusions: Our results do not support a clinical association between chronic Chagas disease and systemic autoimmune diseases. However, prospective studies in areas endemic for Chagas disease should better assess the prevalence of systemic autoimmune diseases and thus a possible relationship with this infection.

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