Chagas disease, caused by the protozoan parasite, Trypanosoma cruzi, is the most important vector-borne disease in Latin America. It is transmitted to humans by triatomine bugs. Despite an ongoing eradication campaign, transmission persists in many areas, particulary in the Gran Chaco region of Argentina where Triatoma infestans is the main vector. The long-term goal of our project is to understand and model the reinfestation processes of human dwellings and peridomestic structures by T. infestans and the transmission of T. cruzi to humans.
Causes
Chagas disease is caused by a parasite. It is common in Latin America but not in the United States. Infected blood-sucking bugs, sometimes called kissing bugs, spread it. When an infected bug bites you, usually on your face, it leaves behind infected waste. You can get the infection if you rub it in your eyes or nose, the bite wound or a cut. The disease can also spread through contaminated food, a blood transfusion, a donated organ or from mother to baby during pregnancy.
Factors depending on parasites (eg, size of the inoculum, repeated inoculations) and individual host differences (immunological or nutritional status) likely contribute to the diversity of clinical forms of Chagas disease.The occurrence of cardiopathy and digestive forms of Chagas disease has been associated with some HLA haplotypes.
Patients may develop heart failure. Swallowing difficulties may be the first symptom of digestive disturbances and may lead to malnutrition. Patients who have parasitic infection of the colon may experience abdominal pain and constipation. Death is usually caused by heart disease.
Symptoms
Chief symptoms of Chagas' disease include constipation, malaise or a feeling of always being tired, the inability to swallow, fever, and varying degrees of discomfort and/or abdominal pain.
Myocarditis (pictured to the right) is an inflammation of the heart muscle, frequently associated with the acute stage of the disease, which usually returns to normal without treatment. After an asymptomatic period of up to 10-13 years, chronic Chagas heart disease, characterized by fibrosis of myocardial fibres, is seen in a high percentage of the carriers of Trypanosoma cruzi infection.
A few people (about 1% of cases) have symptoms soon after infection. The most recognized acute symptom is swelling of the eye on one side of the face, usually at the bite wound or where feces were rubbed into the eye. Other symptoms are tiredness, fever, enlarged liver or spleen, swollen lymph glands, and sometimes a rash, loss of appetite, diarrhea, and vomiting. Infants and very young children can get an often-fatal swelling of the brain.
Treatment
Antiparasitic treatment is most effective early in the course of infection but is not limited to cases in the acute phase. In the United States, this type of treatment is available through CDC. Your health care provider can talk with CDC staff about whether and how you should be treated. Most people do not need to be hospitalized during treatment.
Symptomatic treatment may help people who have cardiac or intestinal problems from Chagas disease. For example, pacemakers and medications for irregular heartbeats may be life saving for some patients with chronic cardiac disease.
Hashimoto's disease is a disease characterized by the immune system attacking the thyroid gland. . A family history of thyroid disorders is common, with the HLADR5 gene most strongly implicated conferring a relative risk of 3 in the UK. The person may experience symptoms of hyperthyroidism at first when the thyroid may actually produce too much thyroid hormones. It is caused by a reaction of the immune system against the thyroid gland. Hashimoto's disease is the most common cause of hypothyroidism in the United States. Hashimoto's disease, also known as chronic lymphocytic thyroiditis, causes inflammation of your thyroid gland that often leads to underactive thyroid (hypothyroidism). Lymphocytic thyroiditis may also occur as a self-limited condition which lasts 2-6 months, resolving spontaneously, and leaving most patients with normal thyroid function. Chronic thyroiditis or Hashimoto's disease is a common thyroid gland disorder that can occur at any age, but it is most often seen in middle aged women. It is more prevalent in women than in men (8:1), and its incidence increases with age Blood tests of thyroid function are used to detect Hashimoto's disease. Patients with this form of thyroiditis sometimes exhibit so few symptoms that the disease may go unnoticed for many years, but eventually it may destroy so much thyroid tissue that hypothyroidism develops.
Many people with this disease have no symptoms. Hashimoto's Disease is often referred to as Hashimoto's thyroiditis, autoimmune thyroiditis, lymphadenoid goiter, struma lymphomatosa, and chronic lymphocytic thyroiditis. Hashimoto's Thyroiditis is not uncommon. Many people with Hashimoto's thyroiditis have other endocrine disorders, such as diabetes, an underactive adrenal gland, or underactive parathyroid glands, and other autoimmune diseases, such as pernicious anemia, rheumatoid arthritis, Sj?gren's syndrome, or systemic lupus erythematosus (lupus). In many cases, Hashimoto's thyroiditis usually results in hypothyroidism, although in its acute phase, it can cause a transient thyrotoxic state. Hashimoto's disease progresses slowly over a number of years and causes chronic thyroid damage, leading to a drop in thyroid hormone levels in your blood. Less commonly, Hashimoto's disease occurs with hypoparathyroidism, adrenal insufficiency, and fungal infections of the mouth and nails in a condition called type 1 polyglandular autoimmune syndrome. The thyroid gland typically becomes and the antibodies the body normally produces to protect the body and fight foreign substances such as bacteria, are found to 'attack' their own thyroid tissue. Treatment with synthetic thyroid hormone replacement medication usually is simple and effective. Natural treatment options also exist.
Causes of Hashimoto's disease
The common causes and risk factor's of Hashimoto's disease include the following:
The exact cause of Hashimoto's disease is unknown.
A reaction of the immune system against the thyroid gland.
If someone in your family has had thyroid disease, you may have an increased risk for Hashimoto's disease.
Hashimoto's thyroiditis is most common among women, particularly older women, and tends to run in families.
It may rarely be associated with other endocrine disorders caused by the immune system.
A combination of factors including heredity, and age may determine your likelihood of developing the disorder.
Hashimoto's Thyroiditis is seen more frequently in people taking extra iodine in their diets.
Symptoms of Hashimoto's disease
Some sign and symptoms related to Hashimoto's disease are as follows:
Fatigue.
Enlarged neck or presence of goiter.
Small or atrophic thyroid gland.
Dry skin.
Joint stiffness.
Excessive sleepiness.
Dry, coarse hair.
Facial swelling.
Hair loss.
Heavy and irregular menses.
Hoarse voice.
An elevated blood cholesterol level.
Intolerance to cold.
Most often, people with Hashimoto's Thyroiditis suffer from symptoms of Hypothyroidism (fatigue, lethargy, decreased metabolic rate).
Treatment of Hashimoto's disease
Here is list of the methods for treating Hashimoto's disease:
Iron supplements.
If Hashimoto's disease causes thyroid hormone deficiency, you may need replacement therapy with thyroid hormone.
Antibiotics to fight infection.
Hormones to suppress or replace thyroid function.
Sucralfate, an ulcer medication.
Long-term prognosis is very good. Most people with the disease can be easily treated.
Cholestyramine (Questran), a medication used to lower blood cholesterol levels.
Replacement therapy with thyroid hormone is given if the hormone is deficient or may be given if there is evidence of mild thyroid failure.
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