title: [Patient with Hansen disease and lepromatous reaction with predominant neural involvement].
abstract: We describe a patient with a diagnosis of Hansen's disease borderline type, presenting as cutaneous lesions and silent multineuritis. Samples of nasal mucus, earlobe and cutaneous lesions were positive for acid-fast bacilli. He was given treatment with rifampin, dapsone and clofazimine. Five years later, he developed fever, poliarthritis, orchitis and hepatic involvement. Searching for acid-fast bacilli in many cutaneous and mucosal locations was fruitfulness. Because of clinical suspicion of erythema nodosum leprosum, he was treated with steroids with improvement of his clinical picture, but subsequently he developed multineuritis with many sensitive symptoms. A high number of bacilli was seen in nerve biopsy. We comment on atypical features of clinical evolution and erythema nodosum leprosum, and emphasize the significance of large number of bacilli into peripheral nerve in contrast with their absence at other levels.
authors.affiliation: Servicio de Medicina Interna, Hospital Juan Ramón Jiménez, Huelva.
authors.forename: J
authors.initials: J
authors.lastname: Gálvez
authors.forename: J M
authors.initials: JM
authors.lastname: López-Domínguez
authors.forename: A
authors.initials: A
authors.lastname: Navarro
authors.forename: R
authors.initials: R
authors.lastname: Creagh
authors.forename: J L
authors.initials: JL
authors.lastname: Casado
authors.forename: I
authors.initials: I
authors.lastname: Chinchón Lara
mesh_terms: D001706:Biopsy; D002991:Clofazimine / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D004893:Erythema Nodosum / Q000209:etiology*; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009443:Neuritis / Q000209:etiology* / Q000473:pathology*; D010525:Peripheral Nerves / Q000473:pathology*; D012293:Rifampin / Q000627:therapeutic use
chemical_list: D007917:Leprostatic Agents; D003622:Dapsone; D002991:Clofazimine; D012293:Rifampin
vernacular_title: Paciente con enfermedad de Hansen y reacción lepromatosa con afectación neural predominante.