Increased level of urinary nitric oxide metabolites in leprosy patients during type 2 reactions and decreased after antireactional therapy.
OBJECTIVE
To assess the urinary nitric oxide metabolites in lepromatous patients in ENL (type 2 reactions) and to compare these metabolites after subsidence of reactions following antireactional therapy. Further to compare the levels in a group of lepromatous leprosy patients without reactions.


METHODS
The initial urine samples were collected from lepromatous leprosy patients when they came with ENL before commencing antireactional therapy and repeat samples were taken after resolution of ENL. Morning urine samples were collected from LL patients without reactions. Nitrites and nitrates in urine were measured using commercially available kit. Mean levels of nitric oxide metabolites of LL patients with ENL and without ENL were compared by student's 't' test. The level during ENL and after resolution was compared by paired 't' test.


RESULTS
The nitric oxide metabolites were analyzed in 14 LL patients with ENL and after resolution of ENL and in 5 LL patients without reaction. The level of urinary nitric oxide metabolite is higher in LL patients in ENL reaction compared to LL patients without reaction (P < 0.04). These levels were reduced significantly with resolution of reaction following antireactional therapy (P < 0.004).


CONCLUSIONS
The findings of this study suggested that the NO/NOM excretion is increased in leprosy patients during ENL episodes. With antireactional therapy (steroids) and clinical improvement the levels are reduced.
Mohanty
Keshar K
KK
National JALMA Institute for Leprosy and Other Mycobacterial Diseases, Taj Ganj, Agra 282 001, India. keshar63@yahoo.com
Gupta
Manisha
M
Girdhar
B K
BK
Girdhar
A
A
Chakma
J K
JK
Sengupta
U
U
D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D016022:Case-Control Studies; D004893:Erythema Nodosum / Q000188:drug therapy* / Q000652:urine; D006801:Humans; D015440:Leprosy, Lepromatous / Q000188:drug therapy* / Q000652:urine; D009569:Nitric Oxide / Q000652:urine*
D000305:Adrenal Cortex Hormones; D009569:Nitric Oxide