[Erythema nodosum leprosum case series report: clinical profile, immunological basis and treatment implemented in health services].

Abstract

Erythema nodosum leprosum is an acute inflammatory event in the chronic course of leprosy. It is considered an immunological disorder and an important cause of morbidity and disability. We evaluate the clinical profile, serology and histopathology 58 erythema nodosum leprosum patients sequentially recruited, from July- December 2000, in an endemic area in Central Brazil (Goiás State). Half of the reactins were considered severe and 66% of the cases had the first episode of reaction during specific treatment. The majority of patients and controls were positive to anti-PGL-I IgM. The more frequent histopathological findings in erythema nodosum leprosum were presence of intracellular acid-fast bacilli, perivascular/peradnexial mononuclear inflammatory infiltrate, and neural aggression. Ninety six percent of the patients were treated with systemic steroid in the first episode. The results point out to the association between ENL and neuritis and the rare adoption of thalidomide as a solely medication in the health services.

• Authors: Jackeline Gomes Guerra, Gerson Oliveira Penna, Lia Cândida Miranda de Castro, Celina Maria Turchi Martelli, Mariane Martins Araújo Stefani, Maurício Barcelos Costa
• Journal: Revista da Sociedade Brasileira de Medicina Tropical (Rev Soc Bras Med Trop) 2004 Sep-Oct Vol. 37 Issue 5 Pg. 384-90 ISSN: 0037-8682 [Print] Brazil
• Vernacular Title: Avaliação de série de casos de eritema nodoso hansênico: perfil clínico, base imunológica e tratamento instituído nos serviços de saúde.
• PMID: 15361954 (Publication Type: English Abstract, Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Antigens, Bacterial
• Glycolipids
• Immunoglobulin M
• Leprostatic Agents
• phenolic glycolipid I, Mycobacterium leprae
• Thalidomide
• Prednisone

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Adult
• Antigens, Bacterial (blood)
• Case-Control Studies
• Endemic Diseases
• Erythema Nodosum (drug therapy, microbiology, pathology)
• Female
• Glycolipids (blood)
• Humans
• Immunoglobulin M (blood)
• Leprostatic Agents (therapeutic use)
• Leprosy, Borderline (drug therapy, immunology, pathology)
• Leprosy, Lepromatous (drug therapy, immunology, pathology)
• Male
• Prednisone (therapeutic use)
• Severity of Illness Index
• Thalidomide (therapeutic use)
• Urban Population