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Case Report: High Mannose-Binding Lectin Serum Determined by MBL2 Genotype and Risk for Clinical Progression to Chagasic Cardiomyopathy: A Case Report of Three Patients

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  • 1 Laboratory of Molecular Immunopathology, Clinical Hospital, Federal University of Paraná, Curitiba, Brazil
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Chagas disease (CD), caused by infection with the parasite Trypanosoma cruzi, leads to severe cardiomyopathy in 20–30% of patients, whereas the remainder may stay asymptomatic and never develop cardiomyopathy or other clinical manifestations. The underlying cause for this variable outcome is not fully characterized, although previous studies have found high levels of circulating mannose-binding lectin (MBL) to be associated with cardiac failure echocardiographic changes. We report three indeterminate (asymptomatic) chronic Chagas patients who were followed up for 10 years. Two of these patients developed chronic chagasic cardiomyopathy (CCC) during this follow-up period and, when genotyped, were found to be carriers of the high MBL producer HYPA/HYPA genotype, suggesting that genetically determined high MBL serum might be associated with the risk of CCC development. These results suggest the use of MBL quantification and MBL2 genotyping as tools for clinical assessment in patients with chronic CD.

Author Notes

Address correspondence to Iara J. Messias-Reason, Setor de Ciências da Saúde, Hospital de Clínicas, Universidade Federal do Paraná, Rua General Carneiro 181, Curitiba 80060-900, Brazil. E-mail: iarareason@hc.ufpr.br

These authors contributed equally to this work.

Financial support: This work was supported by research grants from Coordenação de Aperfeiçoamento de Pessoal Superior (CAPES Edital Parasitologia Básica 32/2010) and Fundação Araucária (PPSUS-01/2016).

Conflict of interest: All authors read and approved the final version of the manuscript and declare that they have no conflicts of interest. Written consent was obtained from the patients to publish their cases.

Authors’ addresses: Kárita Cláudia Freitas Lidani, Fabiana Antunes Andrade, Ronaldo Kiviatcoski Kozlowski, and Paola Rosa Luz, Department of Medical Pathology, Universidade Federal do Parana Hospital de Clinicas, Curitiba, Brazil, E-mails: kari.lidani@gmail.com, fabiana.una@gmail.com, ronaldo.koki@gmail.com, and pazinha.bio@gmail.com. Iara J. Messias-Reason, Department of Immunopathology, Hospital de Clinicas, Curitiba, Brazil, E-mail: iaramessias@yahoo.com.br.