title: The mortality associated with erythema nodosum leprosum in Ethiopia: a retrospective hospital-based study.
abstract: BACKGROUND
  Erythema nodosum leprosum (ENL) is a debilitating multisystem disorder which complicates leprosy. It is characterised by fever, malaise and painful erythematous cutaneous nodules. ENL is often recurrent or chronic in nature and frequently severe. Patients often require prolonged treatment with high doses of oral corticosteroids. There are no data on the mortality associated with treated ENL.
  
  
  METHODS
  The notes of patients who were admitted, discharged, transferred to another facility or died with a diagnosis of leprosy or a leprosy-related complication for a five year period were reviewed.
  
  
  CONCLUSIONS
  414 individuals were identified from the ward database. 312 (75.4%) patient records were located and reviewed. Ninety-nine individuals had ENL and 145 had a Type 1 reaction. The median age of individuals with ENLwas 25 years. Eight patients with erythema nodosum leprosum died compared with two diagnosed with Type 1 reaction. This difference is statistically significant (p = 0.0168, Fisher's Exact Test). There is a significant mortality and morbidity associated with ENL in this Ethiopian cohort. The adverse outcomes seen are largely attributable to the chronic administration of oral corticosteroids used to control the inflammatory and debilitating symptoms of the condition.
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London, United Kingdom.
authors.forename: Stephen L
authors.initials: SL
authors.lastname: Walker
authors.affiliation: Centre Hospitalier Universitaire de Liège, Liege, Belgium.
authors.forename: Eglantine
authors.initials: E
authors.lastname: Lebas
authors.affiliation: ALERT Center, Addis Ababa, Ethiopia.
authors.forename: Shimelis N
authors.initials: SN
authors.lastname: Doni
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London, United Kingdom.
authors.forename: Diana N J
authors.initials: DN
authors.lastname: Lockwood
authors.affiliation: Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London, United Kingdom; ALERT Center, Addis Ababa, Ethiopia.
authors.forename: Saba M
authors.initials: SM
authors.lastname: Lambert
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D002648:Child; D004893:Erythema Nodosum / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D006761:Hospitals; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents