Endocrine dysfunction in patients of leprosy.
BACKGROUND
Leprosy is a chronic granulomatous disease and affects many internal organs in addition to the skin and peripheral nerves. Endocrine dysfunction is often silent and is often missed in patients of leprosy leading to significant morbidity. We studied the presence of occult endocrine disorders in leprosy patients and compared the same with disease parameters.


METHODS
We evaluated 40 patients of leprosy (aged 18-70 years, any duration) in this cross-sectional, observational study. All subjects were assessed for pituitary, thyroid, adrenal, gonadal function, and dynamic testing was done when deemed necessary. The participants were divided into two groups: Group 1 (Leprosy, n = 40) and Group 2 (Controls, n = 20) and the data were analyzed with appropriate statistical tests.


RESULTS
The study participants (35 males, 5 females) had a mean age of 36.4 ± 11.3 years, and duration of the disease was 2.5 ± 5.5 years. Eleven out of 40 patients showed results consistent with an endocrine disorder, including subclinical hypothyroidism (n = 4), sick euthyroid syndrome (n = 3), growth hormone (GH) deficiency (n = 2), primary hypogonadism (n = 2) and secondary hypogonadism in one patient. One patient had partial hypopituitarism (GH deficiency and secondary hypogonadism) and none of the controls showed any hormonal dysfunction. Testosterone levels showed inverse correlation with the number of skin patches (P = 0.0006).


CONCLUSIONS
Occult endocrine dysfunction is seen in a quarter of patients with leprosy. Thyroid and gonadal axes abnormalities are common, and the severity is more in lepromatous forms of the disease. Further large studies are required to confirm the findings observed in our study.
Department of Dermatology, Command Hospital, (CC), Lucknow, Uttar Pradesh, Haryana, India.
Rohit Kumar
RK
Singh
Department of Dermatology, Command Hospital, (CC), Lucknow, Uttar Pradesh, Haryana, India.
Rohit
R
Bhasin
Department of Dermatology, Command Hospital, (CC), Lucknow, Uttar Pradesh, Haryana, India.
Y S
YS
Bisht
Department of Endocrinology, Command Hospital (WC), Chandimandir, Panchkula, Haryana, India.
K V S Hari
KV
Kumar
Endocrinology; hypogonadism; hypothyroidism; lepromatous; leprosy