Anemia hemolítica supostamente relacionada à síndrome hematofagocítica em uma criança atendida no HospitalUniversitário do Oeste do Paraná (HUOP) / Hemolytic anemia supposedly related to hematophagocytic syndrome in a child attended at the University Hospital of the West of Paraná (HUOP)

Um dos quadros clínicos mais comumente encontrado em pacientes internados em serviços de referência é a anemia. Entretanto, ela não é caracterizada como uma doença e sim como consequência de um evento ou de uma patologia. Dentre as diversas manifestações existentes pode-se citar a anemia hemolítica (AH) autoimune, que consiste em um grupo de doenças cuja característica comum é a presença de autoanticorpos, os quais se ligam aos eritrócitos e diminuem o tempo de sobrevida dessas células, sendo um dos eventos autoimunes mais comuns associados a esta condição. Dentre os casos graves está a Síndrome Hematofagocítica ou Linfohistiocitose (SHF), que é uma síndrome rara e potencialmente fatal. Na última década, a SHF tem adquirido notoriedade devido ao aumento da sua incidência. Porém, nem sempre quadro anêmico está relacionado a somente uma causa. Sendo assim, o presente estudo descreverá um caso de anemia hemolítica em uma criança atendida em um hospital universitário, onde se pode apontar mais de uma causa para o quadro hemolítico.

The most commonly clinical event encouterd in patients admitted requently in the hospital are anemia. However, this condition is not characterize as a disease but as consequence of an event or a pathology. Among the anemia we can emphasize autoimmune hemolytic (AH), that consist in a group of diseases whose common feature is the presence of autoantibodies. This tend to bind to erythrocytes and decrease the survival time of these cells. That mechanism is the one of the most common autoimmune events associated with this condition. Between the serious cases is the the Hematophagocytic Syndrome or Lymphohistiocytosis (SHF), which is a rare and potentially fatal syndrome. In the last decade, this syndrome has acquired notoriety due to the increase in its incidence. However, not always an anemic event was related of only one cause. Thus, this study will describe a case of SHF and AH in a child attended at University Hospital of The West of Paraná, in this case we cleary indicated more than one cause for the hemolytic conditions.

Combined parasitological and molecular-based diagnostic tools improve the detection of Trypanosoma cruzi in single peripheral blood samples from patients with Chagas disease

Abstract INTRODUCTION In order to detect Trypanosoma cruzi and determine the genetic profiles of the parasite during the chronic phase of Chagas disease (ChD), parasitological and molecular diagnostic methods were used to assess the blood of 91 patients without specific prior treatment. METHODS Blood samples were collected from 68 patients with cardiac ChD and 23 patients with an indeterminate form of ChD, followed by evaluation using blood culture and polymerase chain reaction. T . cruzi isolates were genotyped using three different genetic markers. RESULTS: Blood culture was positive in 54.9% of all patients, among which 60.3% had the cardiac form of ChD, and 39.1% the indeterminate form of ChD. There were no significant differences in blood culture positivity among patients with cardiac and indeterminate forms. Additionally, patient age and clinical forms did not influence blood culture results. Polymerase chain reaction (PCR) was positive in 98.9% of patients, although comparisons between blood culture and PCR results showed that the two techniques did not agree. Forty-two T . cruzi stocks were isolated, and TcII was detected in 95.2% of isolates. Additionally, one isolate corresponded to TcIII or TcIV, and another corresponded to TcV or TcVI. CONCLUSIONS Blood culture and PCR were both effective for identifying T. cruzi using a single blood sample, and their association did not improve parasite detection. However, we were not able to establish an association between the clinical form of ChD and the genetic profile of the parasite.