Cell-Mediated Immunological Processes in Leprosy

Jl, Turk

doi:10.5935/0305-7518.19700030

Cited by 16 publications

(15 citation statements)

References 24 publications

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“…Since DNCB may give unpleasant burn reactions, and subsequent testing may be difficult to interpret and is not positive in all healthy individuals (Turk, 1969), only three patients with low reactivity have been tested. They all showed evidence of sensitization (Hoyeraal, unpublished results).…”

Section: Discussionmentioning

confidence: 99%

Impaired delayed hypersensitivity in juvenile rheumatoid arthritis.

Høyeraal¹

1973

Annals of the Rheumatic Diseases

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Section: Discussionmentioning

confidence: 99%

Impaired delayed hypersensitivity in juvenile rheumatoid arthritis.

Høyeraal¹

1973

Annals of the Rheumatic Diseases

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“…Patients with lepromatous leprosy have a specific loss of cell-mediated immune response against Mycobacterium leprae and also a diminution in the ability to show other aspects of cell-mediated immune response-for example, contact sensitivity and skin homograft rejection (Hart and Rees, 1967;Bullock, 1968;Turk, 1970;Han et al, 1971).…”

Section: Commentmentioning

confidence: 99%

“…

Case Report A 27-ytar-old Anglo-Indian with end-stage chronic renal failure and hypertension and with a history of fevers, backache, and haematura at the age of 17 years suggestive of chronic pyelonepiritis was referred for dialysis and transplantation in June 1966.

After preliminary haemodialysis he received a cadaveric renal transplant in July with inmnediate diuresis.

…”

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confidence: 97%

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Renal transplantation in leprosy.

Adu¹,

Evans²,

Millard³

et al. 1973

BMJ

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This is the first report of renal transplantation in a patient with lepromatous leprosy although renal failure is an important cause of death in these patients (Brusco and Masanti, 1963;Desikan and Job, 1968;Hart and Rees, 1967).The deficiency of cell-mediated immune response in patients with lepromatous leprosy results in a prolongation of survival of allogenic skin grafts (Heart -and Rees, 1967;Turk, 1970;Han et al., 1971 He was now treated initially with dansone at a dose of 1 mg dailv and the prednisolone was increased to cover the lepra reaction. After initial improvement he developed a further reaction and his therapy was changed to clofazimine. On a dose of 300 mg daily his skin lesions regressed ranidly although he developed a bright red pigmentation of his skin.He remained well until December 1970, when he was readmitted with deterioration of renal function coincident with a further lepra reaction. His creatinine clearance was 5-2 ml/min and a renal biopsy showed the appearances of a chronic rejection process. He was re-established on outpatient haemodialysis. Three months later he developed pneumonia with a cavity in the apex of the lower lobe of the left lung. This was assumed to be tuberculous and he was treated with antituberculosis therapy. He had a severe lepra reaction with rifampicin, but this improved by changing to isoniazid and PAS. However, he then developed a cholestatic jaundice and died a week later, four years nine months after renal transplantation.At necropsy changes affecting many tissues and organs were found. There was a papular rash mainly on the trunk and upper limbs. Some papules contained large clusters of vacuolated cells (lepra cells) in the dermis around vessels and nerves but in none of these cells were any acid-fast bacilli found. Macroscopically many organs were a lilac pink colour which was more noticeable after fixation in a formalin-saline solution. This discoloration, although affecting the stomach, duodenum, and particularly the entire ileum, was conspicuously absent in the greater part of the jejunum. Klebsiella aerogenes was cultured from the lower lobe of the left lung which was uniformly consolidated. No organisms were isolated from a cavity at the apex of this lobe in which there was caseation. Cytomegalovirus was grown from lung tissue and inclusion bodies typical of this virus were seen both in the lungs and submandibular salivary gland. The heart was enlarged (435 g) due mainly to left ventricular hypertrophy and was partly covered by a fibrinous pericarditis. The liver was engorged and many lobules included centrilobular cholestasis. The biliary tract was patent and normal. An abscess from which no micro-organisms were identified replaced the distal third of the body of the pancreas. Both testes had lost their septate pattern and included ill-defined areas of firm grey fibrous tissue. Their tubules were necrotic and the epididymes thickened.Both the patient's own kidneys were equally small with finely and evenly granular surfaces. Microscopically in both kidn...

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“…They are both associated with a reduction in cellular immunity [1,10], Although Hodgkin's disease is frequently associated with various infectious diseases [8], its association with leprosy is rare [3,9]. On the other hand, the incidence of malignant disease in leprous patients is the same as that in matched population groups without leprosy [5,7,9).…”

Section: Discussionmentioning

confidence: 80%

Development of Hodgkin’s Disease in a Patient with Leprosy

Weshler¹,

Leviatan²,

Gordon³

et al. 1978

Oncology

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We present a patient with leprosy who developed Hodgkin’s disease of the nodular sclerosing type. There are two previous reports describing the combination of leprosy and Hodgkin’s disease in a single patient [3, 9]. Hodgkin’s disease was diagnosed 14 months after the complete disappearance of mycobacterium leprae from the skin lesions, under treatment with DDS (diamino-diphenyl-sulfone). Hodgkin’s disease was treated by irradiation and chemotherapy. Obstructive jaundice developed which resolved under treatment by irradiation of the hilar area of the liver, chemotherapy and hormones. During two years of immuno-suppressive therapy, without DDS, no exacerbation of the leprosy occurred.

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Cell-Mediated Immunological Processes in Leprosy

Cited by 16 publications

References 24 publications

Impaired delayed hypersensitivity in juvenile rheumatoid arthritis.

Impaired delayed hypersensitivity in juvenile rheumatoid arthritis.

Renal transplantation in leprosy.

Development of Hodgkin’s Disease in a Patient with Leprosy

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