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[The weight of the spleen in chronic chagasics]
S A Pereira1, B S Corrêa, G P Minicucci
1Disciplina de Patologia Geral, Universidade de Uberaba, Faculdade de Medicina do Triângulo Mineiro.
Insights
In Chagas' disease, increased spleen size is linked to inflammation and heart failure. The study found higher spleen weight in chagasic patients without heart failure, suggesting inflammation
Area of Science:
- Pathology
- Cardiology
- Infectious Diseases
Background:
- Systemic inflammation and chronic venous congestion can cause increased spleen size (reactional hyperplasia and congestive splenomegaly, respectively).
- Chagas' disease involves cardiac inflammation, potentially leading to heart failure and congestive failure.
- The spleen's response to both inflammatory and cardiac processes in Chagas' disease requires investigation.
Purpose of the Study:
- To evaluate the spleen's response to inflammatory and cardiac conditions in Chagas' disease.
- To compare spleen weight in chagasic and non-chagasic patients with and without congestive failure.
Main Methods:
- Retrospective study analyzing autopsy reports from 88 selected cases.
- Patients were divided into four groups: chagasic with/without congestive failure, and non-chagasic with/without congestive failure.
- Data collected included patient age, sex, race, and spleen weight.
Main Results:
- No significant differences in age, sex, or race were observed between the four groups.
- Spleen weight was higher in chagasic patients without congestive failure compared to non-chagasic patients without congestive failure (173.7g vs 117.2g).
- Spleen weight in patients with congestive failure was 183.7g (chagasic) and 206.3g (non-chagasic).
Conclusions:
- The inflammatory component of Chagas' disease significantly contributes to increased spleen weight.
- Hemodynamic alterations from congestive heart failure also play a role in spleen size.
- Spleen weight in Chagas' disease is influenced by both inflammation and cardiac dysfunction.
Abstract:
During the course of systemic inflammatory reactions and chronic venous congestion, the documented phenomenon of increased spleen size is respectively called reactional hyperplasia and congestive splenomegaly. In Chagas' disease, the inflammatory process observed in the heart of chronically infected patients can result in heart failure and ultimately in congestive failure. In order to evaluate the spleen response to both inflammatory and cardiac processes, in this retrospective study we compare the weight of spleens from normal and chagasic patients, with or without congestive failure. Information about patient age, sex, race and spleen weight was collected from autopsy reports. Eighty-eight selected cases were divided into four groups: 1) chagasic patients with congestive failure, 2) chagasic patients without congestive failure, 3) non-chagasic patients with congestive failure, 4) non-chagasic patients without congestive failure. The average age was 44.9 +/- 15.4 years, 53.4% were Caucasians and 70.5% were males, and no significant difference in these parameters was observed between the four groups. The spleen weight for the groups presenting congestive failure was 183.7 +/- 85.9 g for chagasic and 206.3 +/- 101.0 g for non-chagasic patients; for the groups without congestive failure the average spleen weight was 173.7 +/- 118.9 g for the chagasic and 117.2 +/- 52.0 g for non-chagasic patients. The spleen weight was significantly higher for the chagasic patients without congestive failure when compared to the non-chagasic group without congestive failure. These results suggest that the inflammatory component in Chagas' disease plays an important role in the increase of spleen weight together with hemodynamic alterations arising from congestive heart failure.