title: [Leprosy with an unusual course].
abstract: In developed countries, Hansen disease, or leprosy, is a rare and little-known disease. Over the last few years, its prevalence in New Caledonia has remained stable (0.35 per 10,000 inhabitants). We report the case of an 11-year-old child who presented lepromatous leprosy complicated by a type 2 reaction. Despite appropriate treatment, the course was unusual with fever lasting a few weeks associated with asthenia, weight loss, and biological perturbations such as inflammatory syndrome, anemia, and hyperferritinemia. After a brief review of Hansen disease and its complications, we discuss the different hypotheses that can explain the clinical and biological progression of our patient (hemolytic anemia secondary to dapsone, type 2 reaction, and aspects of hemophagocytic syndrome) and describe therapeutic management, which led to a good outcome.
authors.affiliation: Service de pédiatrie, hôpital Magenta, centre hospitalier territorial de Nouvelle-Calédonie, BP J5, 98849 Nouméa cedex, France. auredsf@hotmail.fr
authors.forename: A
authors.initials: A
authors.lastname: Desenfants
authors.forename: E
authors.initials: E
authors.lastname: Huguon
authors.forename: Y
authors.initials: Y
authors.lastname: Polfrit
authors.forename: M
authors.initials: M
authors.lastname: Crouzat
authors.forename: V
authors.initials: V
authors.lastname: Rouleau
authors.forename: V
authors.initials: V
authors.lastname: Chassot
authors.forename: L
authors.initials: L
authors.lastname: Besson-Leaud
authors.forename: I
authors.initials: I
authors.lastname: Missotte
mesh_terms: D000743:Anemia, Hemolytic / Q000139:chemically induced; D002648:Child; D003622:Dapsone / Q000009:adverse effects / Q000627:therapeutic use; D018450:Disease Progression; D004359:Drug Therapy, Combination; D004893:Erythema Nodosum / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D006452:Hemoglobinometry; D006801:Humans; D007917:Leprostatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000175:diagnosis* / Q000188:drug therapy; D051359:Lymphohistiocytosis, Hemophagocytic / Q000175:diagnosis; D009510:New Caledonia; D012307:Risk Factors
chemical_list: D007917:Leprostatic Agents; D003622:Dapsone