Subcurative chemotherapy and fatal post-treatment reactive encephalopathies in African trypanosomiasis

Hunter, C. A., Jennings, F. W., Adams, J. H., Murray, M. and Kennedy, P.G.E. (1992) Subcurative chemotherapy and fatal post-treatment reactive encephalopathies in African trypanosomiasis. Lancet, 339(8799), pp. 956-958. (doi: 10.1016/0140-6736(92)91531-C)

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Publisher's URL: http://dx.doi.org/10.1016/0140-6736(92)91531-C

Abstract

The treatment of late-stage African sleeping sickness in man is often complicated by a post-treatment reactive encephalopathy. The basis of this pathological reaction was investigated in a mouse model of African trypanosomiasis. Subcurative treatment with diminazene aceturate, which did not clear parasites from the central nervous system, resulted in a post-treatment meningoencephalitis similar to that seen in man. By contrast, a curative regimen of melaminylthioarsenite and 5-nitroimidazole, which cleared parasites from the central nervous system, did not cause any pathological reaction in the mice. This result indicates that subcurative treatment leads to the development of the post-treatment encephalopathy. Evidence that this may also be the case in man was provided by the detection of trypanosome DNA with the polymerase chain reaction in the brains of 9 patients who had died as the result of a post-treatment reaction. Our findings suggest that more aggressive treatment regimens, which ensure the elimination of trypanosomes from the central nervous system, may prevent post-treatment reactions in patients.

Item Type:Articles
Additional Information:Originally published as Volume 1, Issue 8799
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Murray, Professor Maxwell and Kennedy, Professor Peter
Authors: Hunter, C. A., Jennings, F. W., Adams, J. H., Murray, M., and Kennedy, P.G.E.
College/School:College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Lancet
Publisher:Elsevier
ISSN:0140-6736
ISSN (Online):1474-547X

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