Number of leprosy reactions during treatment: clinical correlations and laboratory diagnosis

Abstract

Introduction:The occurrence of leprosy reactions, a common event during treatment, may be mostly related to the action of multidrug therapy on Mycobacterium leprae. The clinical and laboratory monitoring of patients with reactions is important, since collecting data that assists in predicting the risk of reactions may help to prevent disability. Methods: This was a sectional study, in order to correlate clinical and laboratory diagnosis with the number of reactions during treatment. Spearman's correlation was used to verify the degree of association between the assessed variables. Results: This study was conducted with 211 patients with leprosy reactions during treatment of M. leprae. The borderline tuberculoid group was the most prevalent clinical form (74/211; 35.1%) and the type one reaction showed the highest frequency (136/211; 64.5%). It was observed that 73.5% (155/211) of reactions occurred within 3 months of the initiation of multidrug therapy. The diagnostic values, including the bacterial indices (BIs) of dermal smears (r = 0.21, p < 0.05) and skin biopsies (r = 0.20; p < 0.05), showed a positive correlation with the number of reactions during treatment. Conclusions: This research showed a positive correlation between bacillary load markers and the number of leprosy reactions. This study provided scientifi c support to future research aiming to elucidate the infl uence of antigenic load on the number of leprosy reactions during treatment.

Differential Expression of IFN-γ, IL-10, TLR1, and TLR2 and Their Potential Effects on Downgrading Leprosy Reaction and Erythema Nodosum Leprosum

“…Higher levels of anti-LAM in the leprosy reaction group is due to the presence of great number of individuals with ENL, since LAM is involved in the formation of immune complexes and in the pathogenesis of erythema nodosum leprosum [39]. High levels of anti-PGL-I in leprosy reactions, independently on the type of reaction, ratify that this antigen is a risk marker for the occurrence of reactions, during treatment and after discharge from MDT, corroborating with previous studies that showed positive serology anti-PGL-I as a risk factor to the reactional condition [3, 7, 40].…”

Whole blood RNA signatures in leprosy patients identify reversal reactions before clinical onset: a prospective, multicenter study

“…Dynamic and unpredictable episodes of increased inflammation, leprosy reactions, can occur before, during and even after treatment, with a higher likelihood to occur in adults than in children 9,10 . These immunological complications are the principal cause of leprosy-associated irreversible neuropathy and are experienced by 30–50% of leprosy patients one or more times, mostly in the unstable borderline lepromatous patients with substantial bacterial loads 11 . Two types of reactions are recognized: reversal reactions or type 1 (RR) and erythema nodosum leprosum (ENL).…”

Evaluation of the cutaneous sensation of the face in patients with different clinical forms of leprosy

“…These result from changes to the immune balance between the host and M . leprae that lead to increased morbidity and impairment of peripheral nerve function [7, 8, 9].…”