Immunomonitoring followed by optimal dec therapy for successful management of clinical filariasis in an endemic area |
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Authors: | B C Harinath M V R Reddy R Alli V K Mehta P Chaturvedi K R Patond S P Kalantri R K C Gupta |
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Institution: | 1. Department of Biochemistry, Mahatma Gandhi Institute of Medical Sciences, Sevagram, 442 102, Wardha, India 2. Department of Surgery, Mahatma Gandhi Institute of Medical Sciences, Sevagram, 442 102, Wardha, India 3. Department of Paediatrics, Mahatma Gandhi Institute of Medical Sciences, Sevagram, 442 102, Wardha, India 4. Department of Orthopaedics, Mahatma Gandhi Institute of Medical Sciences, Sevagram, 442 102, Wardha, India 5. Department of Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, 442 102, Wardha, India 6. Department of Community Medicine, Mahatma Gandhi Institute of Medical Sciences, Sevagram, 442 102, Wardha, India
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Abstract: | Lymphatic filariasis continues to be the major cause of clinical morbidity in India and other developing tropical countries.
One of the major lacunae in the effective management of clinical filarial cases is the non-availability of a suitable diagnostic
test for confirming filaria aetiology in acute, chronic and occult clinical cases where microfilariae (mf) are not usually
seen in peripheral circulation. Studies in our laboratory have shown the usefulness of filarial antibody and antigen assays
using microfilarial excretory-secretory (mf ES) antigen in detecting microfilaraemic, acute and chronic filarial cases and
in confirming filarial aetiology in occult infections. Diethylcarbamazine citrate (DEC) is the drug of choice for lymphatic
filariasis. Different regimens of DEC have been explored in the treatment of microfilaraemic cases. Immunomonitoring has shown
that the seroconversion of antigen and antibody positivity was found to be very helpful in determining appropriate period
of DEC treatment for clinical relief and cure in clinical filarial patients and further they did not have recurrence in most
of the cases. Optimal DEC (6mg/kg body wt/day for 21 days each month for 3–12 months) therapy was found to be very effective
in acute and atypical clinical manifestations such as asthmatic bronchitis, pulmonary eosinophilia, monoarthritis, recurrent
upper respiratory tract infections (URI), pneumonia (super imposed infections) in children and minimal hydrocele, epididymoorchitis,
lymphangitis, lymphadenitis, acute abdomen, central serous retinopathy, tenosynovitis, pain and swelling in limbs and joints
in adults living in filaria endemic areas. |
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Keywords: | Filariasis immunodiagnosis immunomonitoring DEC therapy |
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