Introduction: Leprosy is a chronic granulomatous infection with a variety of clinical spectrum caused by Mycobacterium leprae (M. leprae) that is highly influenced by host immune response. In leprosy, vitamin D acts as an immunomodulator through a VDR-mediated antimicrobial pathway that affects the innate immune system to bacterial killing. M. leprae inhibits VDR activity through the down-regulation of CYP27B1. Elevated 1.25(OH)2D levels are required to modulate cathelicidin antimicrobial peptide (CAMP) production, which leads to reduced 25(OH)D level. This study aimed to analyze the difference in serum vitamin D level between leprosy patients and healthy people.Methods: This research was an analytical observational study with a cross-sectional design involving 20 patients with new cases of leprosy and 20 controls. The diagnosis of leprosy was confirmed through physical examination and laboratory examination. We conducted blood sampling and measurement of serum vitamin D (25(OH)D) level in both groups using the chemiluminescence immunoassay (CLIA) method. The collected data were then processed and analyzed statistically using the Mann-Whitney test.Result: In this study, we found that the mean serum vitamin D level in leprosy patients (22.27 ± 5.418 ng/mL) was lower than controls (33.00 ± 1.913 ng/mL), and the difference was statistically significant (p < 0.05). The mean serum vitamin D level in male leprosy patients (23.69 ± 4.034 ng/mL) was higher than females (16.55 ± 7.081 ng/mL), and was highest in patients aged 36 – 45 years (25.314 ± 2.2945 ng/mL).Conclusion: Serum vitamin D level was significantly lower in leprosy patients than in controls. Serum vitamin D level in leprosy patients was higher in the male group and was highest in patients aged 36 – 45 years.
Leprosy is a chronic progressive granulomatous disease that caused by Mycobacterium leprae, an intracellular obligate bacteria. Leprosy can be treated using multidrug therapy (MDT) that can be associated with hepatotoxicity as their side effects. We included 14 patients that were all diagnosed with multibacillary leprosy, but with four drops out persons. Liver function evaluations before MDT were in the normal range. After 1st, 2nd, and 3rd months of MDT, liver function test in research subjects also in the normal range even though there is variation in this value. There is a risk of hepatotoxicity of MDT; therefore, liver function test should be done periodically for early detection of any liver dysfunction.
BACKGROUND: Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae which affects skin, peripheral nerves, and other body parts including bone, ear, eye, and nose. Nasal manifestation of leprosy may be found in the early stage with non-specific symptoms such as nasal congestion. In advanced stage, destruction of bone structures and cartilages may result in deformities. However, nasal manifestation as the only symptom in early stage can lead to delayed diagnosis. CASE REPORT: We reported a case of multibacillary leprosy in a 26-year-old male with tumor like nasal deformity for 1 year and lump in the ear lobes since 8 years ago. Initially, there was nasal discharge, unfrequent epistaxis, followed by loss of smelling perception, without associated pain, or numbness since childhood. Lesions on the trunk, palms, and soles were also noted since 2 years ago. The physical examination revealed tumor with crusts and fissures on the nasal tip; accompanied by saddle nose. Slit skin smear revealed acid-fast bacilli with bacteriological index of 4+ in solid form. Hence, he was diagnosed as multibacillary leprosy with Grade 2 disability. The prognosis was poor due to permanent deformities. CONCLUSION: Early diagnosis and initiation of treatment are crucial in the management of this debilitating and stigmatized disease.
BACKGROUND: Leprosy or Hansen’s disease is an infectious disease caused by Mycobacterium leprae (M. leprae) bacilli which results in chronic infections in humans that affect the peripheral nerves, skin, and other organs such as the eyes, mucous membranes, bones, and testicles. Leprosy has a variety of clinical presentations, depending on the cell-mediated immunity of the host. Leprosy is classified by the World Health Organization (WHO) as paucibacillary type (PB) and multibacillary type (MB) depending on the number of lesions. This multicenter study aims to provide representation of leprosy types and its epidemiology in Indonesia. AIM: The purpose of this study is to find out the epidemiology according to the leprosy type in 13 teaching hospitals in Indonesia between 2018 and 2020. METHODS: This is a descriptive study with cross-sectional design. All patients with the diagnosis of PB or MB type of leprosy who underwent Multidrug Therapy (MDT) treatment between 2018 and 2020 were included in this study. Data collection was carried out by tracing medical records data in 13 teaching hospitals in Indonesia. RESULTS: A total of 2129 leprosy patients were included in this study. There were 232 cases (10.8%) of PB leprosy and 1897 cases (89.1%) of MB leprosy. The average age of the patients is 38.7 years (SD ± 16.2 years). Males are more affected by leprosy (n = 1,441; 67.7%) compared to female (n = 688; 32.3%). CONCLUSION: Leprosy remains as a national health problem. The increasing cases of MB leprosy in Indonesia are caused by several factors including the lack of knowledge about leprosy, the delay in diagnosis of leprosy, and the stigma of leprosy within the community; therefore, it becomes a challenge to eliminate leprosy in Indonesia.
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