Primary muscle disease: definition of a 25-kDa polypeptide myopathic specific chagas antigen.

The sera from patients with primary heart and skeletal muscle diseases, hospitalized patients without intrinsic muscle disease from an area endemic for Trypanosoma cruzi infections, and normal subjects (N = 693) were studied for the presence of immunoglobulin G (IgG) antisarcolemma activity using serologic methods. The prevalence of elevated serum IgG antisarcolemma activity from patients with chronic Chagas' cardiomyopathy, idiopathic cardiomyopathy, polymyositis, and Duchenne muscular dystrophy was 58.9 +/- 10.4% (N = 101) (P less than 0.001 when compared to normal subjects). Two of twelve (16.7%) patients with acute T. cruzi infection and parasitemia developed elevated antisarcolemma titers, and 9/46 (19.6%) patients with chronic T. cruzi infection without evidence of cardiomyopathy yielded high antisarcolemma titers. On the other hand, patients with chronic T. cruzi infection with advanced cardiomyopathy yielded high antisarcolemma titers in 35/74 (47.3%) (P less than 0.001 when compared to normal subjects). Radioimmunoprecipitation showed a circulating antibody to a 25-kDa T. cruzi polypeptide (P25) in 16/17 (94.1%) patients with advanced cardiomyopathy and T. cruzi infection. No such antibody was shown in 12 asymptomatic subjects with chronic T. cruzi infection.

Immunity against infection with Trypanosoma cruzi in mice correlates with presence of antibodies against three trypomastigote polypeptides.

Repeated immunizations of CF1 mice with irradiated noninfectious Trypanosoma cruzi trypomastigotes resulted in partial protection against infection with live parasites. It also induced a limited number of antibody species that were reactive in Western blots with trypomastigote but not with epimastigote or amastigote polypeptides. These antibody species were strongly reactive with a 100,000-dalton polypeptide and much less reactive with at least two polypeptides greater than 200,000 daltons. Immunization with epimastigotes induced antibodies against a 57,000-dalton epimastigote-specific polypeptide but did not induce protective immunity.

Postlymphographic cerebral lipid embolization in the vena cava superior syndrome.

A recent case of Lipiodol Ultrafluid embolism to the brain is reported. Pathogenetic concepts involving right-to-left shunts, and lympho-venous shunts with pulmonary capillary overloading are reviewed. In addition, it is suggested that a local disturbance in cerebral circulation due to a cava superior syndrome may contribute to the severe cerebral symptoms.