Abstract
Ten patients with chronic Chagas' disease were treated with nifurtimox (8-9 mg/kg/day) associated with betamethasone (9 mg/day initially and then gradually reduced) during 60 days, with one exception. It was intended to combine the respective anti-parasitic and anti-inflammatory actions of these drugs. The expected stimulating effect of betamethasone on the infection could possibly enhance the anti-Trypanosoma cruzi action of nifurtimox. Long term persistence of negative xenodiagnosis, used to control the results, was observed in only one of the cases. Regaridng the other patients, post-treatment positivity of xenodiagnosis and serological testes attested the failure of this therapy. As this study has demonstrated, adequate and long term follow-up of treated cases is necessary to ensure correct conclusions.
Highlights
Ten patients with chronic Chagas’ disease were treated with nifurtimox (8-9mg/kg/day) associated with betamethasone (9mg/day initially and gradually reduced) during 60 days, with one exception
O binômio constituído por infecção pelo T. cruzi e imunodepressão tem estado comumente em foco, merecendo considerações em estudos de várias ordens, que incluem também avaliações relacionadas com pacientes1 2 3 5 6 7 8 9 10 11
Revista do Instituto de Medicina Tropical de São Paulo 11: 280-284, 1969
Summary
Compuseram a casuística dez pacientes acometidos da doença Chagas em fase crônica. Efetuamos xenodiagnósticos e exames sorológicos mensalmente antes do tratamento; após o mesmo geralmente os referidos exames também foram praticados a cada mês (no decurso dos dois primeiros anos) e, posteriormente, a intervalos maiores. Em cada xenodiagnóstico utilizamos quatro caixas, cada uma com dez ninfas de terceiro estádio do Triatoma infestans; a procura de T. cruzi, em três lâminas com o pool de fezes de cinco insetos, ocorreu em 30 e 60 dias após os repastos sangüíneos, havendo sacrifício deles por ocasião do exame final. Eventualmente o xenodiagóstico foi realizado com 20 triatomíneos (2 caixas) por falta momentânea de insetos. Tabela 1 - Tratamento com nifurtimox e corticóide de pacientes com doença de Chagas em fase crônica: xenodiagnósticos efetuados prévia e posteriormente
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