Francis H, Awadzi K, Ottesen E A
Am J Trop Med Hyg. 1985 May;34(3):529-36. doi: 10.4269/ajtmh.1985.34.529.
To determine definitively whether or not the severity of the Mazzotti reaction was correlated with infection intensity, as determined by skin snip quantification, 21 infected Ghanian patients were evaluated during 7 days of treatment with 200 mg/day of diethylcarbamazine. Serial blood, urine and skin biopsy samples were collected during the progression of the Mazzotti reaction. Hypotension, fever, adenitis and pruritus were all correlated with infection intensity in these patients while arthralgia and tachycardia were not. Peripheral blood eosinopenia and neutrophilia also correlated with intensity of infection and appeared to reflect the accumulation of degranulating eosinophils around "mobilized" microfilariae that migrated from the dermis to the epidermis after diethylcarbamazine (DEC). Other mobilized microfilariae apparently were cleared by the liver and resulted in abnormal liver enzyme levels in the serum which, again, were directly correlated with the patients' microfilarial density. Though the severity of the Mazzotti reaction clearly correlated with intensity of infection, the different times of onset of symptoms, and cellular and serum chemistry changes indicate that there are probably multiple infection intensity-dependent mechanisms responsible for mediating this complex reaction.
为了明确马佐蒂反应的严重程度是否与通过皮肤活检定量测定的感染强度相关，对21名感染的加纳患者在接受200毫克/天乙胺嗪治疗的7天内进行了评估。在马佐蒂反应进展过程中收集了系列血液、尿液和皮肤活检样本。在这些患者中，低血压、发热、腺炎和瘙痒均与感染强度相关，而关节痛和心动过速则不然。外周血嗜酸性粒细胞减少和中性粒细胞增多也与感染强度相关，似乎反映了在乙胺嗪（DEC）作用下从真皮迁移到表皮的“活动”微丝蚴周围脱颗粒嗜酸性粒细胞的聚集。其他活动的微丝蚴显然被肝脏清除，并导致血清中肝酶水平异常，这同样与患者的微丝蚴密度直接相关。尽管马佐蒂反应的严重程度与感染强度明显相关，但症状出现的不同时间以及细胞和血清化学变化表明，可能有多种感染强度依赖性机制介导这种复杂反应。
