Clinical Correlates of C1q-Precipitating Substances in the Sera of Patients with Leprosy *

Rh, Gelber; Dj, Drutz; Wv, Epstein; Fasal, Paul

doi:10.4269/ajtmh.1974.23.471

Cited by 24 publications

(4 citation statements)

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“…LL patients suffer from acute, episodic, exacerbated reactional states called erythema nodosum leprosum (ENL), which are characterized by crops of tender, erythematous, subcutaneous nodules and systemic manufestations of pyrexia, malaise, neuritis, arthralgia, and proteinuria. The mechanisms underlying ENL have been attributed to immune complex-mediated injury as evidenced by histopathology (37), presence of immunoglobulin and complement in lesions (36), and circulating immune complexes (1,5,14) and complement-degradative products (1,6).…”

Section: 004) Both Phytohemagglutinin-induced Generalmentioning

confidence: 99%

Natural emergence of antigen-reactive T cells in lepromatous leprosy patients during erythema nodosum leprosum

Laal¹,

Bhutani²,

Nath³

1985

Infect Immun

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Fifteen lepromatous leprosy (LL) patients undergoing erythema nodosum leprosum (ENL) reactions were compared with 13 stable, uncomplicated, anergic individuals of the same leprosy background. ENL patients showed significant antigen-induced leukocyte migration inhibition (migration index = 0.058 + 0.01), paralleling the values obtained with a responder tuberculoid leprosy population (migration index = 0.04 ± * Corresponding author.

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Section: 004) Both Phytohemagglutinin-induced Generalmentioning

confidence: 99%

Natural emergence of antigen-reactive T cells in lepromatous leprosy patients during erythema nodosum leprosum

Laal¹,

Bhutani²,

Nath³

1985

Infect Immun

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“…ENL may develop as a complication oflepromatous leprosy. An Arthus reaction type of vasculitis (Turk & Bryceson 1971;Waters et al 1971;Wemambu et al 1969) is caused by the deposition of immune complexes in the vessel walls (Gelber et al 1974;Moran et al 1972;RojasEspinosa et al 1972), leading to the generalised appearance of red painful nodules in the skin, often accompanied by iritis, orchitis, arthritis, rhinitis, lymphadenitis and glomerulonephritis; fever is always present (Alonso 1975;Drutz & Gutman 1973;Jolliffe 1977;Turk et al 1971;Waters 1974;Waters et al 1971).…”

Section: Erythema Nodosum Leprosummentioning

confidence: 96%

Thalidomide in Human Immunodeficiency Virus (HIV) Patients

Günzler¹

1992

Drug Safety

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The sedative thalidomide was withdrawn from the market 30 years ago because of its teratogenic and neurotoxic adverse effects. The compound was later discovered to be extremely effective in the treatment of erythema nodosum leprosum, a complication of lepromatous leprosy. This effect is probably due to a direct influence on the immune system, because thalidomide possesses no antibacterial activity. The compound is presently used as an experimental drug in the treatment of a variety of diseases with an autoimmune character, including recurrent aphthosis of nonviral and nonfungal origin in human immunodeficiency virus (HIV) patients. This article reviews the most important chemical and pharmacokinetic properties of thalidomide. The possible mechanisms of the nonsedative effects of thalidomide with respect to the safety of its use in HIV patients are discussed. Because the mechanism of the immunomodulatory effect of thalidomide is unknown, the possibility that the administration of this compound will accelerate the deterioration of the immunological status of HIV patients cannot be excluded. Clinical evidence suggests that thalidomide may aggravate the condition of patients with preexisting peripheral neuropathy. Hypersensitivity reactions to thalidomide may occur more frequently in HIV patients than in other patient groups. Because of the teratogenic activity of thalidomide, reliable contraception must be provided to female patients of childbearing age. Before the introduction of thalidomide therapy to an HIV patient presenting with oral ulcers, a fungal or viral origin of the lesions should be excluded. Thalidomide should not be used in patients with preexisting HIV-related peripheral polyneuropathy, polyradiculopathy or encephalopathy. In patients experiencing a complete remission, the discontinuation of thalidomide treatment and its reintroduction in the case of a relapse are preferable to maintenance therapy.

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“…The widespread systemic manifestations of this reaction suggest the existence of circulating immune complexes in addition to the fixed complexes in the skin. This reasoning is strengthened by the demonstration of circulating Clq precipitates that may be immune complexes (Gelber et al, 1974), and the presence of renal lesions consistent with the pathology of immune complex glomerulonephritis in patients with Type 2 reaction (Shwe, 1971;Drutz & Gutman, 1973;Bullock, Callerame & Panner, 1974).…”

Section: Type 2 (Enl) Reactionmentioning

confidence: 99%

Leprosy reactional states and their treatment

Jolliffe

1977

Br J Dermatol

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Clinical Correlates of C1q-Precipitating Substances in the Sera of Patients with Leprosy *

Cited by 24 publications

References 0 publications

Natural emergence of antigen-reactive T cells in lepromatous leprosy patients during erythema nodosum leprosum

Natural emergence of antigen-reactive T cells in lepromatous leprosy patients during erythema nodosum leprosum

Thalidomide in Human Immunodeficiency Virus (HIV) Patients

Leprosy reactional states and their treatment

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