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GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE
A Journal on Internal Medicine and Pharmacology
Indexed/Abstracted in: BIOSIS Previews, EMBASE, Scopus, Emerging Sources Citation Index
Gazzetta Medica Italiana Archivio per le Scienze Mediche 1999 August;158(4):127-32
Transfusional toxoplasmosis, cardiovascular disorders, diabete mellitus and thalidomide
Barbosa Vosgerau J. C.
Centro Municipal de Especialidades, Secretariat of Health from Ponta Grossa
Chronic toxoplasmosis may affect any organ but its onset is very slow over the years. It is reported a patient that had irritability, severe joints/bone, skin lesions with severe pruritus during the first month after blood transfusion, progressively severe lymphedema, severe heart failure, anasarca, bradycardia, tachycardia, extrasystoles, atrioventricular block, aorta calcification, hypertension, toxoplasmic septic shock, diabetes mellitus, chronic alkaline phosphatase increase, acute transaminases elevation, urinary infection with urinary incontinence, acute renal failure, chronic anemia, hypercholesterolemia, hypertriglyceridemia, hypocholesterolemia, eosinophilia, basophilia, leukocytosis, neutropenia, neutrofilia, unresponsives to ususal measures. These clinical/laboratory disorders remitted or had a marked improvement with roxithromycin 900 mg/day, dapsone, pyrimethamine, but the response were more conspicuous with thalidomide 6.5 g/day was added to the medication. It is postulated that these disorders are related to IFN-γ, TNF-α e and IFN-α host intoxication triggered by toxoplasma. It was concluded: 1. for a efficient treatment is necessary not only to kill the parasites (with the specific anti-toxoplasmosis medicines in a triplet scheme) but mainly to reduce the possible cytokines intoxication triggered in the host by toxoplasma, with thalidomide in a dose depentent manner. 2. Thalidomide has a critical role in the treatment of toxoplasmosis-related heart, liver, kidney failure.