Adverse reactions following diethylcarbamazine (DEC) intake in 'endemic normals', microfilaraemics and elephantiasis patients

This paper reports on adverse reactions following a 12-day course of 6 mg/k g diethylcarbamazine (DEC) therapy in brugian filariasis patients in Indone sia. Microfilaria-positive individuals (n = 26), (endemic normals' (n = 12) and elephantiasis patients (n = 17) were included in the study. Fever, hea dache and body aches started between 2 and 24 h after DEC intake. Adverse r eactions were categorized into 'no or mild', 'moderate' or 'severe' dependi ng on the total reaction score. Four microfilaraemic individuals (15.4%) su ffered from severe adverse reactions and their pre-treatment microfilarial levels (geometric mean, GM = 3060 mf/10 mt) were significantly higher than in the 5 microfilaraemic individuals (19.2%) suffering from moderate reacti ons (GM = 1268 mf/10 mt) 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 patie nts after DEC intake. Two elephantiasis patients with moderate reactions ha d high levels of circulating microfilariae at pre-treatment (2097 and 7375 mf/10 mt). Concentrations of DEC were measured in plasma, but could not exp lain the differences in the severity of adverse reactions.