[The sequelae of Hansen's disease. (Pathologic viewpoint of etiologies, morphologies and countermeasures)].
The proportion of glomerulonephritis, often a sequence of arteriolitis, among the sequelae of Hansen's disease after the introduction of chemotherapy increased markedly in Japan and nullified that of once prevalent tuberculosis after 1960s. However, most significant aftermath of the disease for numbers of years in the past have been peripheral nerve injuries worldwide for which effective countermeasures are yet to be developed. In this brief autopsy cases study from 1960s to 1990s, we confirmed the presence of cases in which arteriolitis and resulted infarction of peripheral nerves and not M. leprae itself were shown to be the major cause of axonal damages. There were also cases in which the accumulation of the bacilli without vascular changes did not damage the axons. The cases as these could not be solitary but should be rather common in this time of chemotherapy. If so, the methods to reconstruct nerves and blood vessels by promoting those regeneration should be developed to cope with the situation for surgeon, assisted by pathologists.
Leprosy Research Center, National Institute of Infectious Diseases, 4-2-1, Aoba, Higashimurayama, Tokyo-189-0002, JPN. e-mats@nih.go.jp
Eiichi
E
Matsuo
D005921:Glomerulonephritis / Q000209:etiology / Q000628:therapy; D006801:Humans; D007918:Leprosy / Q000150:complications / Q000473:pathology*; D010523:Peripheral Nervous System Diseases / Q000209:etiology / Q000628:therapy; D014657:Vasculitis / Q000209:etiology / Q000628:therapy