Dreyer G, Pires M L, de Andrade L D, Lopes E, Medeiros Z, Tenorio J, Coutinho A, Noroes J, Figueredo-Silva J
Departmento de Parasitologia, Centro de Pesquisas Aggeu Magelhães/FIOCRUZ, Recife, Pernambuco, Brazil.
Trans R Soc Trop Med Hyg. 1994 Mar-Apr;88(2):232-6. doi: 10.1016/0035-9203(94)90311-5.
To determine the tolerance to diethylcarbamazine (DEC) treatment of patients with Bancroftian filariasis, 193 individuals (138 asymptomatic microfilaraemic, 30 amicrofilaraemic diseased patients and 25 asymptomatic amicrofilaraemic endemic residents) were enrolled in a prospective trial with different dose schedules, in a hospital and outpatient clinic setting in Brazil. Systemic adverse reactions, localized adverse reactions, and side effects, related to microfilariae, adult worms and the drug itself, were evaluated. Systemic reactions occurred irrespective of the DEC dose and schedule in about 40% of the microfilariae carriers, but not in amicrofilaraemic diseased patients or residents; they usually consisted of microscopic haematuria, followed by fever and malaise. Localized reactions were manifested by the appearance of inflammatory reactions, mainly in the scrotal area. Nodules containing degenerating adult worms developed mainly in the scrotal lymphatics of microfilaraemic patients, diseased amicrofilaraemic patients, and residents. Drowsiness, which increased with higher doses of DEC, was the most common side effect in both microfilaraemic and amicrofilaraemic individuals, followed by nausea and gastric upset. The results indicate that the occurrence of systemic and local adverse reactions was unrelated to either the dose of DEC or the pretreatment microfilarial density. The severity of systemic reactions was proportional to the microfilarial density. Side effects were dependent on the drug dosage irrespective of infection status.
为确定班氏丝虫病患者对乙胺嗪（DEC）治疗的耐受性，在巴西的一家医院和门诊环境中，193人（138名无症状微丝蚴血症患者、30名无微丝蚴血症的患病患者和25名无症状无微丝蚴血症的流行区居民）参与了一项采用不同剂量方案的前瞻性试验。评估了与微丝蚴、成虫和药物本身相关的全身不良反应、局部不良反应及副作用。约40%的微丝蚴携带者无论DEC的剂量和给药方案如何都会出现全身反应，但无微丝蚴血症的患病患者或居民则不会出现；全身反应通常先是镜下血尿，随后是发热和不适。局部反应表现为炎症反应，主要出现在阴囊区域。含有退化成虫的结节主要在微丝蚴血症患者、无微丝蚴血症的患病患者及居民的阴囊淋巴管中形成。嗜睡在微丝蚴血症和无微丝蚴血症个体中都是最常见的副作用，且随着DEC剂量增加而加重，其次是恶心和胃部不适。结果表明，全身和局部不良反应的发生与DEC剂量或治疗前微丝蚴密度均无关。全身反应的严重程度与微丝蚴密度成正比。副作用取决于药物剂量，与感染状态无关。
