[Functional and immunologic involvement in human African trypanosomiasis caused by Trypanosoma gambiense]. / Atteintes fonctionnelles et immunologiques au cours de la trypanosomiase humaine africaine à Trypanosoma gambiense.

In the first phase of our study, a group of 58 patients were investigated: electromyographic abnormalities were recorded in 52%, electrocardiographic abnormalities in 48%, electroencephalographic abnormalities in 47%, spirographic abnormalities in 31%. Impairments of central nervous system occur classically in Trypanosoma gambiense infection, while cardiac damage is more frequent in T. rhodesiense infection. Noted lesions are due to an immunological mechanism. In the second phase, 25 patients and controls from the same area were investigated. We tried to confirm existence and pathogeny of cardiac impairments in T. gambiense infection: incidence, symptoms, clinical and electrocardiographic signs, disturbances of cardiac rythm. There were ST segment, T wave and PR interval changes. Chest X ray showed cardiomegaly. Echocardiography revealed right ventricular dilatation. There were pericardial effusion and thickening. The immunological tests showed significantly higher IgM and immunoconglutinin levels in the patient group together with the presence of anti-heart antibodies of the IgM and IgG class. Our results suggest that cardiac impairments may be due to immune complexes.