02100nas a2200361   4500000000100000008004100001260001300042653001000055653001200065653001800077653002300095653001600118653001100134653001100145653001200156653000900168653001800177653001500195653001900210653001800229100001300247700001500260700001500275700001500290700001600305700001300321700001400334245008700348300001000435490000700445520127200452022001401724       1988                            d  c1988 Mar10aAdult10aAnimals10aDexamethasone10aDiethylcarbamazine10aEosinophils10aFemale10aHumans10aleprosy10aMale10aMicrofilariae10aOnchocerca10aonchocerciasis10aSkin Diseases1 aStingl P1 aPierce P F1 aConnor D H1 aGibson D W1 aStraessle T1 aRoss M A1 aRibas J L00aDoes dexamethasone suppress the Mazzotti reaction in patients with onchocerciasis?  a77-850 v453 a<p>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.</p>  a0001-706X