title: Adverse reactions following diethylcarbamazine (DEC) intake in 'endemic normals', microfilaraemics and elephantiasis patients.
abstract: This paper reports on adverse reactions following a 12-day course of 6 mg/kg diethylcarbamazine (DEC) therapy in brugian filariasis patients in Indonesia. Microfilaria-positive individuals (n = 26), 'endemic normals' (n = 12) and elephantiasis patients (n = 17) were included in the study. Fever, headache and body aches started between 2 and 24 h after DEC intake. Adverse reactions were categorized into 'no or mild', 'moderate' or 'severe' depending on the total reaction score. Four microfilaraemic individuals (15.4%) suffered from severe adverse reactions and their pre-treatment microfilarial levels (geometric mean, GM = 3060 mf/10 mL) were significantly higher than in the 5 microfilaraemic individuals (19.2%) suffering from moderate reactions (GM = 1268 mf/10 mL) and in the 17 microfilaraemic patients (65.4%) who experienced no or mild reactions (GM = 6 mf/10 mL)(P < 0.001 and P < 0.001, respectively). Endemic normals showed no or mild adverse reactions. No or mild adverse reactions were also recorded in all but 2 elephantiasis patients after DEC intake. Two elephantiasis patients with moderate reactions had high levels of circulating microfilariae at pre-treatment (2097 and 7375 mf/10 mL). Concentrations of DEC were measured in plasma, but could not explain the differences in the severity of adverse reactions.
authors.affiliation: Department of Parasitology, Leiden University Medical Centre, The Netherlands.
authors.forename: M
authors.initials: M
authors.lastname: Haarbrink
authors.forename: A J
authors.initials: AJ
authors.lastname: Terhell
authors.forename: G K
authors.initials: GK
authors.lastname: Abadi
authors.forename: Y
authors.initials: Y
authors.lastname: Mitsui
authors.forename: M
authors.initials: M
authors.lastname: Yazdanbakhsh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000909:Antibodies, Helminth / Q000097:blood; D002009:Brugia / Q000276:immunology; D002648:Child; D004049:Diethylcarbamazine / Q000009:adverse effects*; D004605:Elephantiasis, Filarial / Q000188:drug therapy* / Q000276:immunology / Q000469:parasitology; D005260:Female; D005369:Filaricides / Q000009:adverse effects*; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D000909:Antibodies, Helminth; D005369:Filaricides; D007074:Immunoglobulin G; D004049:Diethylcarbamazine