51
|
Martinez JD, Cardenas JA. Treatment of Leprosy and Leprosy Reactions. CURRENT TREATMENT OPTIONS IN INFECTIOUS DISEASES 2017. [DOI: 10.1007/s40506-017-0127-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
|
52
|
Nazario AP, Ferreira J, Schuler-Faccini L, Fiegenbaum M, Artigalás O, Vianna FSL. Leprosy in Southern Brazil: a twenty-year epidemiological profile. Rev Soc Bras Med Trop 2017; 50:251-255. [DOI: 10.1590/0037-8682-0229-2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 11/25/2016] [Indexed: 11/21/2022] Open
Affiliation(s)
- Ana Paula Nazario
- Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil; Universidade Luterana do Brasil, Brazil
| | - Jair Ferreira
- Universidade Federal do Rio Grande do Sul, Brazil; Hospital de Clínicas de Porto Alegre, Brasil
| | - Lavínia Schuler-Faccini
- Hospital de Clínicas de Porto Alegre, Brasil; Universidade Federal do Rio Grande do Sul, Brazil; Instituto Nacional de Genética Médica Populacional, Brasil
| | | | - Osvaldo Artigalás
- Grupo Hospitalar Conceição, Brazil; Prefeitura Municipal de Porto Alegre, Brazil
| | - Fernanda Sales Luiz Vianna
- Hospital de Clínicas de Porto Alegre, Brasil; Universidade Federal do Rio Grande do Sul, Brazil; Instituto Nacional de Genética Médica Populacional, Brasil; Hospital de Clínicas de Porto Alegre, Brasil
| |
Collapse
|
53
|
Abstract
Thalidomide and its derivatives are currently under investigation for their antiangiogenic, immunomodulative, and anticancer properties. Current methods used to synthesize these compounds involve multiple steps and extensive workup procedures. Described herein is an efficient microwave irradiation green synthesis method that allows preparation of thalidomide and its analogs in a one-pot multicomponent synthesis system. The multicomponent synthesis system developed involves an array of cyclic anhydrides, glutamic acid, and ammonium chloride in the presence of catalytic amounts of 4-N,N-dimethylaminopyridine (DMAP) to produce thalidomide and structurally related compounds within minutes in good isolated yields.
Collapse
|
54
|
Pereira GMB, Pessolani MCV, Sarno EN. Response to Comment on "DNA Sensing via TLR-9 Constitutes a Major Innate Immunity Pathway Activated during Erythema Nodosum Leprosum". JOURNAL OF IMMUNOLOGY (BALTIMORE, MD. : 1950) 2016; 197:4184-4185. [PMID: 27864547 DOI: 10.4049/jimmunol.1601713] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
| | | | - Euzenir N Sarno
- Oswaldo Cruz Institute, FIOCRUZ, Rio de Janeiro 21040-360, Brazil
| |
Collapse
|
55
|
Crawford CL. Comment on “DNA Sensing via TLR-9 Constitutes a Major Innate Immunity Pathway Activated during Erythema Nodosum Leprosum”. THE JOURNAL OF IMMUNOLOGY 2016; 197:4183-4184. [DOI: 10.4049/jimmunol.1601645] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
|
56
|
Chaves W, Castro C, Garzón KC, Fontalvo MT, Viracacha GC, Ruano CA, Suárez JA. Eritema nudoso secundario a reacción tipo 2 como manifestación de lepra lepromatosa. Un reporte de caso. REPERTORIO DE MEDICINA Y CIRUGÍA 2016. [DOI: 10.1016/j.reper.2016.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
57
|
Lepromatous leprosy and human immunodeficiency virus co-infection associated with phenomenon of Lucio versus immune reconstitution inflammatory syndrome. INFECTIO 2016. [DOI: 10.1016/j.infect.2015.10.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
58
|
Chan MMF, Smoller BR. Overview of the Histopathology and Other Laboratory Investigations in Leprosy. CURRENT TROPICAL MEDICINE REPORTS 2016. [DOI: 10.1007/s40475-016-0086-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
59
|
Amorim FM, Nobre ML, Ferreira LC, Nascimento LS, Miranda AM, Monteiro GRG, Dupnik KM, Duthie MS, Reed SG, Jeronimo SMB. Identifying Leprosy and Those at Risk of Developing Leprosy by Detection of Antibodies against LID-1 and LID-NDO. PLoS Negl Trop Dis 2016; 10:e0004934. [PMID: 27658042 PMCID: PMC5033353 DOI: 10.1371/journal.pntd.0004934] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 07/29/2016] [Indexed: 11/19/2022] Open
Abstract
Leprosy is caused by Mycobacterium leprae infection and remains a major public health problem in many areas of the world. Challenges to its timely diagnosis result in delay in treatment, which is usually associated with severe disability. Although phenolic glycolipid (PGL)-I has been reported as auxiliary diagnostic tool, currently there is no serological assay routinely used in leprosy diagnosis. The aim of this study was to evaluate the effectiveness of two related reagents, LID-1 and LID-NDO, for the detection of M. leprae infection. Sera from 98 leprosy patients, 365 household contacts (HHC) and 98 endemic controls from Rio Grande do Norte, Brazil, were evaluated. A subgroup of the HHC living in a hyperendemic area was followed for 7–10 years. Antigen-specific antibody responses were highest in multibacillary (MB) at the lepromatous pole (LL/BL) and lowest in paucibacillary (PB) at the tuberculoid pole (TT/BT). A positive correlation for both anti-LID-1 and anti-LID-NDO antibodies was found with bacterial burden (LID-1, r = 0.84, p<0.001; LID-NDO, r = 0.82, p<0.001), with higher sensitivity than bacilloscopy. According to Receiver Operating Curve, LID-1 and LID-NDO performed similarly. The sensitivity for MB cases was 89% for LID-1 and 95% for LID-NDO; the specificity was 96% for LID-1 and 88% for LID-NDO. Of the 332 HHC that were followed, 12 (3.6%) were diagnosed with leprosy in a median time of 31 (3–79) months after recruitment. A linear generalized model using LID-1 or LID-NDO as a predictor estimated that 8.3% and 10.4% of the HHC would become a leprosy case, respectively. Together, our findings support a role for the LID-1 and LID-NDO antigens in diagnosing MB leprosy and identifying people at greater risk of developing clinical disease. These assays have the potential to improve the diagnostic capacity at local health centers and aid development of strategies for the eventual control and elimination of leprosy from endemic areas. Despite the substantial decrease in its prevalence, leprosy continues to be a worldwide challenge. Early diagnosis and treatment are important to interrupt transmission. Currently, there is no gold standard for the diagnosis of leprosy. Bacilloscopy and histopathology studies are complementary exams that provide high specificity but low sensitivity. It is therefore important to seek alternative tools to achieve rapid and accurate diagnosis. The state of Rio Grande do Norte, in Brazil, has municipalities’ that are considered hyperendemic for leprosy, such as Mossoró, the one included in this study. This city presented an average of new case detection rate (NCDR) of 45.4/100.000 inhabitants per year from 2001 to 2013, much higher than Brazil’s NCDR, which is currently 15.3. Here, we show that the utility of the recombinant antigens LID-1 and LID-NDO to diagnose MB patients and detect asymptomatic M. leprae infection. In addition, we showed that antibody levels were related to the clinical form of leprosy as well as to the bacillary load. Interestingly, we observed that serum levels of LID-1/LID-NDO antibodies can be used to predict leprosy development among HHC. The assays have the potential to eventually be implemented as point of care at local health centers.
Collapse
Affiliation(s)
- Francianne M. Amorim
- Department of Biochemistry, Bioscience Center, and Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Maurício L. Nobre
- Department of Biochemistry, Bioscience Center, and Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Post-graduate Program in Tropical Medicine, Instituto Oswaldo Cruz, Fiocruz, Rio de Janeiro, Brazil
- Hospital Giselda Trigueiro, Rio Grande do Norte Health Secretariat, Natal, Rio Grande do Norte, Brazil
| | - Leonardo C. Ferreira
- Department of Biochemistry, Bioscience Center, and Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Larissa S. Nascimento
- Department of Biochemistry, Bioscience Center, and Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Alesson M. Miranda
- Department of Biochemistry, Bioscience Center, and Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Glória R. G. Monteiro
- Department of Biochemistry, Bioscience Center, and Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Kathryn M. Dupnik
- Center for Global Health, Weill Cornell Medical College, New York, New York, United States of America
| | - Malcolm S. Duthie
- Infectious Disease Research Institute, Seattle, Washington, United States of America
| | - Steven G. Reed
- Infectious Disease Research Institute, Seattle, Washington, United States of America
| | - Selma M. B. Jeronimo
- Department of Biochemistry, Bioscience Center, and Institute of Tropical Medicine of Rio Grande do Norte, Universidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
- Instituto Nacional de Ciência e Tecnologia de Doenças Tropicais (INCT-DT), Salvador, Bahia, Brazil
- * E-mail:
| |
Collapse
|
60
|
Yap FB, Kiung ST, Yap JB. Quality of life in patients with erythema nodosum leprosum in Kuala Lumpur, Malaysia. Indian Dermatol Online J 2016; 7:255-8. [PMID: 27559497 PMCID: PMC4976401 DOI: 10.4103/2229-5178.185495] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND There is a paucity of data on quality of life issues in patients with leprosy suffering from erythema nodosum leprosum (ENL). Thus, we aim to study the effect of ENL on quality of life. MATERIALS AND METHODS This cross-sectional study was conducted in Hansen's Clinic, Hospital Kuala Lumpur between January 2010 and December 2013 among patients with multibacillary leprosy using the Dermatology Life Quality Index (DLQI). RESULTS A total of 153 patients participated with 31.4% suffering from ENL. The mean age at presentation was 40.5 ± 16.49 years. The mean DLQI was 7.1 ± 3.72. Patients with ENL were younger (mean age 36.5 vs. 42.4, P = 0.026), had higher mean bacteriologic index (4.3 vs. 3.8, P = 0.004), had physical deformities (47.9% vs. 31.4%, P = 0.049), and had higher mean DLQI score (9.1 vs. 6.2, P < 0.001). All the DLQI domains were higher in patients suffering from ENL except the treatment domain. Symptoms and feeling was the domain with the largest effect followed by daily activities and leisure. Personal relationship had the lowest effect. CONCLUSION Quality of life impairment in patients with leprosy in Malaysia is moderate, with larger effect among patients with ENL. The impairment in ENL is comparable to itchy skin conditions such as urticarial and is worse than chronic skin disease such as psoriasis. Thus, it is essential that management of leprosy incorporate quality of life issues.
Collapse
Affiliation(s)
- Felix B Yap
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Sungai Long Campus, Selangor DE, Malaysia; Department of Dermatology, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Sze T Kiung
- Department of Anaesthesiology and Intensive Care, Hospital Kuala Lumpur, Jalan Pahang, Kuala Lumpur, Malaysia
| | - Jeffrey B Yap
- Department of Surveying, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Sungai Long Campus, Selangor DE, Jalan Pahang, Kuala Lumpur, Malaysia
| |
Collapse
|
61
|
Schmitz V, Prata RBDS, Barbosa MGDM, Mendes MA, Brandão SS, Amadeu TP, Rodrigues LS, Ferreira H, Costa FDMR, dos Santos JB, Pacheco FDS, Machado ADM, Nery JADC, Hacker MDA, Sales AM, Pinheiro RO, Sarno EN. Expression of CD64 on Circulating Neutrophils Favoring Systemic Inflammatory Status in Erythema Nodosum Leprosum. PLoS Negl Trop Dis 2016; 10:e0004955. [PMID: 27556927 PMCID: PMC4996526 DOI: 10.1371/journal.pntd.0004955] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 08/05/2016] [Indexed: 11/25/2022] Open
Abstract
Erythema Nodosum Leprosum (ENL) is an immune reaction in leprosy that aggravates the patient´s clinical condition. ENL presents systemic symptoms of an acute infectious syndrome with high leukocytosis and intense malaise clinically similar to sepsis. The treatment of ENL patients requires immunosuppression and thus needs to be early and efficient to prevent both disabilities and permanent nerve damage. Some patients experience multiple episodes of ENL and prolonged use of immunosuppressive drugs may lead to serious adverse effects. Thalidomide treatment is extremely effective at ameliorating ENL symptoms. Several mechanisms have been proposed to explain the efficacy of thalidomide in ENL, including the inhibition of TNF production. Given its teratogenicity, thalidomide is prohibitive for women of childbearing age. A rational search for molecular targets during ENL episodes is essential to better understand the disease mechanisms involved, which may also lead to the discovery of new drugs and diagnostic tests. Previous studies have demonstrated that IFN-γ and GM-CSF, involved in the induction of CD64 expression, increase during ENL. The aim of the present study was to investigate CD64 expression during ENL and whether thalidomide treatment modulated its expression. Leprosy patients were allocated to one of five groups: (1) Lepromatous leprosy, (2) Borderline leprosy, (3) Reversal reaction, (4) ENL, and (5) ENL 7 days after thalidomide treatment. The present study demonstrated that CD64 mRNA and protein were expressed in ENL lesions and that thalidomide treatment reduced CD64 expression and neutrophil infiltrates-a hallmark of ENL. We also showed that ENL blood neutrophils exclusively expressed CD64 on the cell surface and that thalidomide diminished overall expression. Patient classification based on clinical symptoms found that severe ENL presented high levels of neutrophil CD64. Collectively, these data revealed that ENL neutrophils express CD64, presumably contributing to the immunopathogenesis of the disease.
Collapse
Affiliation(s)
- Veronica Schmitz
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | | | | | - Thaís Porto Amadeu
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luciana Silva Rodrigues
- Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Helen Ferreira
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | | | | | | | | | | - Anna Maria Sales
- Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | | | | |
Collapse
|
62
|
Dias AA, Silva CO, Santos JPS, Batista-Silva LR, Acosta CCD, Fontes ANB, Pinheiro RO, Lara FA, Machado AM, Nery JAC, Sarno EN, Pereira GMB, Pessolani MCV. DNA Sensing via TLR-9 Constitutes a Major Innate Immunity Pathway Activated during Erythema Nodosum Leprosum. THE JOURNAL OF IMMUNOLOGY 2016; 197:1905-13. [DOI: 10.4049/jimmunol.1600042] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 06/12/2016] [Indexed: 01/01/2023]
|
63
|
O'Connor G, Gleeson LE, Fagan-Murphy A, Cryan SA, O'Sullivan MP, Keane J. Sharpening nature's tools for efficient tuberculosis control: A review of the potential role and development of host-directed therapies and strategies for targeted respiratory delivery. Adv Drug Deliv Rev 2016; 102:33-54. [PMID: 27151307 DOI: 10.1016/j.addr.2016.04.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 04/04/2016] [Accepted: 04/20/2016] [Indexed: 12/18/2022]
Abstract
Centuries since it was first described, tuberculosis (TB) remains a significant global public health issue. Despite ongoing holistic measures implemented by health authorities and a number of new oral treatments reaching the market, there is still a need for an advanced, efficient TB treatment. An adjunctive, host-directed therapy designed to enhance endogenous pathways and hence compliment current regimens could be the answer. The integration of drug repurposing, including synthetic and naturally occurring compounds, with a targeted drug delivery platform is an attractive development option. In order for a new anti-tubercular treatment to be produced in a timely manner, a multidisciplinary approach should be taken from the outset including stakeholders from academia, the pharmaceutical industry, and regulatory bodies keeping the patient as the key focus. Pre-clinical considerations for the development of a targeted host-directed therapy are discussed here.
Collapse
Affiliation(s)
- Gemma O'Connor
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland; Department of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin and St. James's Hospital, D08 W9RT, Dublin, Ireland.
| | - Laura E Gleeson
- Department of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin and St. James's Hospital, D08 W9RT, Dublin, Ireland.
| | - Aidan Fagan-Murphy
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland; SFI Centre for Research in Medical Devices (CURAM), Dublin 2, Ireland.
| | - Sally-Ann Cryan
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland; Trinity Centre for Bioengineering, Trinity College Dublin, Dublin 2, Ireland; SFI Centre for Research in Medical Devices (CURAM), Dublin 2, Ireland.
| | - Mary P O'Sullivan
- Department of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin and St. James's Hospital, D08 W9RT, Dublin, Ireland.
| | - Joseph Keane
- Department of Clinical Medicine, Institute of Molecular Medicine, Trinity College Dublin and St. James's Hospital, D08 W9RT, Dublin, Ireland.
| |
Collapse
|
64
|
Lorenzo ME, Carter JB, Barnes JA, Nazarian RM. CASE RECORDS of the MASSACHUSETTS GENERAL HOSPITAL. Case 19-2016. A 65-Year-Old Man with End-Stage Renal Disease and a Pruritic Rash. N Engl J Med 2016; 374:2478-88. [PMID: 27332907 DOI: 10.1056/nejmcpc1512457] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- Mayra E Lorenzo
- From the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Massachusetts General Hospital, and the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Harvard Medical School - both in Boston
| | - Joi B Carter
- From the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Massachusetts General Hospital, and the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Harvard Medical School - both in Boston
| | - Jeffrey A Barnes
- From the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Massachusetts General Hospital, and the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Harvard Medical School - both in Boston
| | - Rosalynn M Nazarian
- From the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Massachusetts General Hospital, and the Departments of Dermatology (M.E.L., J.B.C.), Medicine (J.A.B.), and Pathology (R.M.N.), Harvard Medical School - both in Boston
| |
Collapse
|
65
|
Oktaria S, Effendi EH, Indriatmi W, van Hees CLM, Thio HB, Sjamsoe-Daili ES. Soil-transmitted helminth infections and leprosy: a cross-sectional study of the association between two major neglected tropical diseases in Indonesia. BMC Infect Dis 2016; 16:258. [PMID: 27278453 PMCID: PMC4898373 DOI: 10.1186/s12879-016-1593-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2015] [Accepted: 05/26/2016] [Indexed: 11/24/2022] Open
Abstract
Background The clinical spectrum of leprosy is dependent on the host immune response against Mycobacterium leprae or the newly discovered Mycobacterium lepromatosis antigen. Helminth infections have been shown to affect the development of several diseases through immune regulation and thus may play a role in the clinical manifestations of leprosy and leprosy reactions. The purpose of this study is to determine the proportion of helminth infections in leprosy and its association with the type of leprosy and type 2 leprosy reaction (T2R). Methods History or episode of T2R was obtained and direct smear, formalin-ether sedimentation technique, and Kato-Katz smear were performed on 20 paucibacillary (PB) and 61 multibacillary (MB) leprosy participants. Results There are more helminth-positive participants in MB leprosy compared to PB (11/61 versus 0/20, p = 0.034) and in T2R participants compared to non-T2R (8/31 versus 3/50, p = 0.018). Conclusions Our results suggest that soil-transmitted helminth infections may have a role in the progression to a more severe type of leprosy, as well as the occurrence of T2R. These findings could serve as a fundamental base for clinicians to perform parasitological feces examination in patients who have MB leprosy and severe recurrent reactions to rule out the possibility of helminth infection. Further secondary confirmation of findings are needed to support these conclusions.
Collapse
Affiliation(s)
- Salma Oktaria
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia. .,Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Evita Halim Effendi
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Wresti Indriatmi
- Department of Dermatology and Venereology, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - Colette L M van Hees
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hok Bing Thio
- Department of Dermatology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | |
Collapse
|
66
|
Mussani F, Mendoza-Londono R, Lara-Corrales I. Borderline Lepromatous Leprosy: A Case to Remember. J Cutan Med Surg 2016; 20:176-7. [PMID: 26888945 DOI: 10.1177/1203475415611380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
67
|
|
68
|
Arthur C, Gardner JM, Han JY. A 9-Year-Old Boy With a Chronic Rash. J Pediatric Infect Dis Soc 2015; 4:381-4. [PMID: 26407266 DOI: 10.1093/jpids/piv033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2015] [Accepted: 04/28/2015] [Indexed: 11/13/2022]
Affiliation(s)
| | - Jared M Gardner
- Division of Dermatopathology, University of Arkansas for Medical Sciences, Little Rock
| | | |
Collapse
|
69
|
Leon KE, Salinas JL, McDonald RW, Sheth AN, Fairley JK. Complex Type 2 Reactions in Three Patients with Hansen's Disease from a Southern United States Clinic. Am J Trop Med Hyg 2015; 93:1082-6. [PMID: 26304919 DOI: 10.4269/ajtmh.15-0052] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 07/01/2015] [Indexed: 12/13/2022] Open
Abstract
In non-endemic countries, leprosy, or Hansen's disease (HD), remains rare and is often underrecognized. Consequently, the literature is currently lacking in clinical descriptions of leprosy complications in the United States. Immune-mediated inflammatory states known as reactions are common complications of HD. Type 1 reactions are typical of borderline cases and occur in 30% of patients and present as swelling and inflammation of existing skin lesions, neuritis, and nerve dysfunction. Type 2 reactions are systemic events that occur at the lepromatous end of the disease spectrum, and typical symptoms include fever, arthralgias, neuritis, and classic painful erythematous skin nodules known as erythema nodosum leprosum. We report three patients with lepromatous leprosy seen at a U.S. HD clinic with complicated type 2 reactions. The differences in presentations and clinical courses highlight the complexity of the disease and the need for increased awareness of unique manifestations of lepromatous leprosy in non-endemic areas.
Collapse
Affiliation(s)
- Kristoffer E Leon
- Emory University, Atlanta, Georgia; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jorge L Salinas
- Emory University, Atlanta, Georgia; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Robert W McDonald
- Emory University, Atlanta, Georgia; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Anandi N Sheth
- Emory University, Atlanta, Georgia; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Jessica K Fairley
- Emory University, Atlanta, Georgia; Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| |
Collapse
|