{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T20:40:04Z","timestamp":1723063204616},"reference-count":29,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,6,1]]},"abstract":"<jats:p>We report a patient with severe multi-bacillary leprosy complicated by recurrent episodes of erythema nodosum necrotisans that required thalidomide and\/or corticosteroids during follow-up. Although the patient was from an area to which Chagas disease is endemic, this diagnosis was initially missed and was only investigated when heart failure developed in the patient. The difficulties of managing erythema nodosum necrotisans and heart failure concomitantly and those involved in excluding the diagnosis of acute myocarditis caused by reactivation of Chagas disease secondary to the immunosuppressive regimen are discussed. Other potential causes for the heart failure and possible interactions between the two diseases and their treatments are discussed. We also reviewed the literature for the association between leprosy and Chagas disease, both of which are highly endemic in Brazil. This case emphasizes the importance of searching for subclinical co-infections in leprosy patients because reactions frequently develop during specific treatment in these patients, and these reactions require prolonged therapy with immunosuppressive drugs.<\/jats:p>","DOI":"10.4269\/ajtmh.2011.10-0547","type":"journal-article","created":{"date-parts":[[2011,6,1]],"date-time":"2011-06-01T18:44:22Z","timestamp":1306953862000},"page":"973-977","source":"Crossref","is-referenced-by-count":2,"title":["A Patient with Erythema Nodosus Leprosum and Chagas Cardiopathy: Challenges in Patient Management and Review of the Literature"],"prefix":"10.4269","volume":"84","author":[{"given":"Maria \u00c2ngela B.","family":"Trindade","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noemia B.","family":"Carvalho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elaini C.","family":"Belfort","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Pagliari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erika","family":"Gakiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neusa Y.","family":"Sakai-Valente","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gil","family":"Benard","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria A.","family":"Shikanai-Yasuda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Wkly Epidemiol Rec","first-page":"333","volume":"33","author":"Global leprosy situation, World Health Organization","year":"2010"},{"year":"2006","series-title":"Estimacion Cuantitativa de la Enfermedad de Chagas en las Americas","author":"Bolletin de la Organizacion Panamericana de la Salud","key":"R2"},{"year":"2010","series-title":"Portal de Sa\u00fade","key":"R3"},{"key":"R4","series-title":"Int J Lepr","first-page":"255","article-title":"Classification of leprosy according to immunity: a five-group system","volume":"34","author":"Ridley","year":"1966"},{"key":"R5","series-title":"Lepr Rev","first-page":"153","article-title":"The time interval between the start of anti-leprosy treatment and the development of reactions in borderline patients","volume":"49","author":"Naafs","year":"1978"},{"key":"R6","series-title":"Trans R Soc Trop Med Hyg","first-page":"329","article-title":"Towards understanding the pathology of erythema nodosum leprosum","volume":"102","author":"Kahawita","year":"2008"},{"key":"R7","series-title":"Cardiovasc Res","first-page":"96","article-title":"Pathophisiology of the heart in Chagas'disease: current status and new developments","volume":"60","author":"Higuchi","year":"2003"},{"key":"R8","series-title":"Rev Inst Med Trop Sao Paulo","first-page":"67","article-title":"Chagas disease cardiomyopathy: current concepts of an old disease","volume":"50","author":"Bilate","year":"2008"},{"key":"R9","series-title":"PLoS Negl Trop Dis","first-page":"e718","article-title":"\u201cManifesto\u201d for advancing the control and elimination of neglected tropical diseases","volume":"4","author":"Hotez","year":"2010"},{"key":"R10","series-title":"Arq Min Leprol","first-page":"155","article-title":"Lepra e doen\u00e7a de Chagas","volume":"8","author":"Diniz","year":"1948"},{"key":"R11","series-title":"Rev Soc Bras Med Trop","first-page":"31","article-title":"Hansen\u00edase e doen\u00e7a de Chagas. 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