[Erythema nodosum leprosum case series report: clinical profile, immunological basis and treatment implemented in health services].
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.
Guerra
Jackeline Gomes
JG
Departamento de Medicina Tropical e Dermatologia, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO. jgguerra@terra.com.br
Penna
Gerson Oliveira
GO
Castro
Lia Cândida Miranda de
LC
Martelli
Celina Maria Turchi
CM
Stefani
Mariane Martins Araújo
MM
Costa
Maurício Barcelos
MB
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000942:Antigens, Bacterial / Q000097:blood*; D016022:Case-Control Studies; D019353:Endemic Diseases; D004893:Erythema Nodosum / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D005260:Female; D006017:Glycolipids / Q000097:blood*; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood*; D007917:Leprostatic Agents / Q000627:therapeutic use; D015439:Leprosy, Borderline / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D015440:Leprosy, Lepromatous / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D008297:Male; D011241:Prednisone / Q000627:therapeutic use; D012720:Severity of Illness Index; D013792:Thalidomide / Q000627:therapeutic use; D014505:Urban Population
D000305:Adrenal Cortex Hormones; D000942:Antigens, Bacterial; D006017:Glycolipids; D007075:Immunoglobulin M; D007917:Leprostatic Agents; C045169:phenolic glycolipid I, Mycobacterium leprae; D013792:Thalidomide; D011241:Prednisone