Does dexamethasone suppress the Mazzotti reaction in patients with onchocerciasis?
نویسندگان
چکیده
The Mazzotti reaction is a frequent complication in patients with onchocerciasis being treated with diethylcarbamazine (DEC); and more severe manifestations of this reaction may be unacceptable in many patients. It has recently been demonstrated that prednisone modifies the severity of this reaction and reduces the microfilaricidal activity of DEC. A clinical trial was performed at the National Leprosy Training Center in Wau, Sudan, to evaluate the clinical and histologic effect of the use of corticosteroids in patients receiving DEC. Administration of a low dose of dexamethasone (3 mg/day), begun after onset of the Mazzotti reaction, modifies the progression of the Mazzotti reaction without interfering with the microfilaricidal efficacy of DEC. Pretreatment with low-dose dexamethasone--prior to beginning DEC therapy--prevents the development of the Mazzotti reaction and greatly reduces the microfilaricidal activity. Administration of diphenhydramine, after onset of the Mazzotti reaction, has no effect on the course and intensity of the Mazzotti reaction nor on microfilaricidal activity. We recommend that low-dose corticosteroids be administered in conjunction with DEC--after onset of the Mazzotti reaction--and that they be tapered rapidly.
منابع مشابه
Sowda-type onchocerciasis in Guatemala.
The usual pattern of onchocercal dermatitis in Africans and Guatemalans is a generalized and symmetrical dermatitis located on legs, arms and trunk. These patients appear to be anergic, with depressed immune responses and numerous microfilariae in the skin. In contrast, "sowda" is an unusual type of onchocercal dermatitis found in Yemenites and in a minority of African patients. Here the dermat...
متن کاملDoes Adding Dexamethasone to Clomiphene Citrate Improve Ovulation in PCOS Patients? A Triple - Blind Randomized Clinical Trial Study
متن کامل
3) Onchocerciasis
Historical view The parasite, Onchocerca volvulus, was first detected in a Ghanaian by a German missionary in 1890 and was nominated Filaria volvulus by Leuckart (1893). No pathogenicity of the parasite was found yet. In 1915, however, R. Robles reported the new distribution of this filarial parasite in Guatemala, Central America, after enormous parasitological, clinical and epidemiological stu...
متن کاملDeseril and diethylcarbamazine in the treatment of onchocerciasis.
SIR-We have previously experienced great difficulty in using diethylcarbamazine (dec) for the treatment of heavily infected patients in Cameroon (FUGLSANG & ANDERSON, 1974; ANDERSON et al., 1976). SALAZARMALLEN (personal communication) believes that an injection of Deseril (Sandoz) alleviates the initial adverse effects of dec in the skin and conjunctiva, and thus makes the use of this drug mor...
متن کاملComparing the Prophylactic Effect of Pregabalin with that of Aminophylline Plus Dexamethasone on Postdural Puncture Headache after Spinal Anesthesia in Cesarean Section: A Double-Blind Controlled Randomized Clinical Trial
Background: Headache is yet considered an undesirable complication of spinal anesthesia as a selective method in cesarean section. The present study was conducted to compare the prophylactic effect of pregabalin with that of aminophylline plus dexamethasone on postdural puncture headache after spinal anesthesia in cesarean section. Materials and Methods: The present double-blind controlled rand...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Acta tropica
دوره 45 1 شماره
صفحات -
تاریخ انتشار 1988