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RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Pearson JM , 1981. The use of corticosteroids in leprosy. Lepr Rev 52: 293–298.
-
2.
Croft RP , Nicholls PG , Richardus JH , Smith WC , 2000. The treatment of acute nerve function impairment in leprosy: Results from a prospective cohort study in Bangladesh. Lepr Rev 71: 154–168.
-
3.
Kiran KU , Stanley JN , Pearson JM , 1985. The outpatient treatment of nerve damage in patients with borderline leprosy using a semi-standardized steroid regimen. Lepr Rev 56: 127–134.
-
4.
Walker SL et al.; Erythema Nodosum Leprosum International STudy Group 2017. A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. PLoS Negl Trop Dis 11: e0005716.
-
5.
Sardana K , Khurana A , Bhushan P , Sardana K & Khurana A Jopling’s Handbook of Leprosy. 7th ed. New Delhi, India: CBS, 311–321.
-
6.
Croft RP , Nicholls PG , Richardus JH , Smith WCS , 2000. The treatment of acute nerve function impairment in leprosy: Results from a prospective cohort study in Bangladesh. Lepr Rev 71: 154–168.
-
7.
van Brakel WH , Khawas IB , 1996. Nerve function impairment in leprosy: An epidemiological and clinical study–Part 2: Results of steroid treatment. Lepr Rev 67: 104–118.
-
8.
Saunderson PA , Gebre S , Desta K , Byass P , Lockwood DN , 2000. The pattern of leprosy-related neuropathy in the AMFES patients in Ethiopia: Definitions, incidence, risk factors and outcome. Lepr Rev 71: 285–308.
-
9.
Lockwood DN , Darlong J , Govindharaj P , Kurian R , Sundarrao P , John AS , 2017. AZALEP a randomized controlled trial of azathioprine to treat leprosy nerve damage and type 1 reactions in India: Main findings. PLoS Negl Trop Dis 11: e0005348.
-
10.
Jitendra SSV , Bachaspatimayum R , Devi AS , Rita S , 2017. Azathioprine in chronic refractory erythema nodosum leprosum: A case report. J Clin Diagn Res 11: FD01–FD02.
-
11.
Duraes SM , Salles Sde A , Leite VR , Gazzeta MO , 2011. Azathioprine as a steroid sparing agent in leprosy type 2 reactions: Report of nine cases. Lepr Rev 82: 304–309.
-
12.
Lambert SM , Nigusse SD , Alembo DT , Walker SL , Nicholls PG , Idriss MH , Yamuah LK , Lockwood DN , 2016. Comparison of efficacy and safety of cyclosporine to prednisolone in the treatment of erythema nodosum leprosum: Two randomised, double blind, controlled pilot studies in Ethiopia. PLoS Negl Trop Dis 10: e0004149.
-
13.
Sena CB , Salgado CG , Tavares CM , Da Cruz CA , Xavier MB , Do Nascimento JL , 2006. Cyclosporine A treatment of leprosy patients with chronic neuritis is associated with pain control and reduction in antibodies against nerve growth factor. Lepr Rev 77: 121–129.
-
14.
Jesus JB , Sena CBC , Macchi BM , do Nascimento JLM , 2022. Cyclosporin A as an alternative neuroimmune strategy to control neurites and recover neuronal tissues in leprosy. Neuroimmunomodulation 29: 15–20.
-
15.
Narang T , Kamat D , Sardana K & Khurana A Jopling’s Handbook of Leprosy. 7th ed. New Delhi, India: CBS, 252–223.
-
16.
Saini C , Siddiqui A , Ramesh V , Nath I , 2016. Leprosy reactions show increased Th17 cell activity and reduced FOXP3+ Tregs with concomitant decrease in TGF-beta and increase in IL-6. PLoS Negl Trop Dis 10: e0004592.
-
17.
Vieira AP , Trindade MA , Pagliari C , Avancini J , Sakai-Valente NY , Duarte AJ , Benard G , 2016. Development of type 2, but not type 1, leprosy reactions is associated with a severe reduction of circulating and in situ regulatory T-cells. Am J Trop Med Hyg 94: 721–727.
-
18.
Costa MB , Hungria EM , Freitas AA , Sousa AL , Jampietro J , Soares FA , Stefani MM , 2018. In situ T regulatory cells and Th17 cytokines in paired samples of leprosy type 1 and type 2 reactions. PLoS One 13: e0196853.
-
19.
World Health Organization , 2023. Leprosy. Available at: https://www.who.int/news-room/fact-sheets/detail/leprosy. Accessed July 15, 2023.
-
20.
World Health Organization , 2021. Leprosy: Number of New Cases 2021. Available at: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/number-of-new-leprosy-cases. Accessed July 5, 2024.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 4470 | 4470 | 141 |
| Full Text Views | 48 | 48 | 13 |
| PDF Downloads | 52 | 52 | 11 |
Case Report: Recurrent Type 2 Leprosy Reaction Associated with Multiple Nerve Function Impairments Refractory to Steroids: A Therapeutic Challenge
Ananta Khurana
drananta2014@gmail.com
Ananta Khurana
Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Savitha Sharath
Savitha Sharath
Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Abhishek Panchal
Abhishek Panchal
Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Kabir Sardana
Kabir Sardana
Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Saurabh Gupta
Saurabh Gupta
Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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ABSTRACT.
Nerve function impairment (NFI) in leprosy results in serious deformities of the face, hands, and feet and contributes significantly to the stigma associated with the disease. Most literature on NFI focuses on either type 1 reaction–associated NFI, or the silent neuropathy, whereas NFI associated with type 2 reaction (T2R) is less well researched. The latter, however, can be more refractory to conventional treatment, not solely owing to its recurrent nature. We present a therapeutically challenging case of a 31-year-old male with borderline lepromatous leprosy with recurrent T2R associated with recurrent and progressive sensorimotor NFI, largely unresponsive to oral steroids and multibacillary, multidrug therapy.
Author Notes
Current contact information: Ananta Khurana, Savitha Sharath, Abhishek Panchal, Kabir Sardana, and Saurabh Gupta, Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India, E-mails: drananta2014@gmail.com, savitharavivarma@gmail.com, rockabhi437@gmail.com, article.sardana@gmail.com, and saurabhlotr@gmail.com.
ProCite
RefWorks
Reference Manager
BibTeX
Zotero
EndNote
-
1.
Pearson JM , 1981. The use of corticosteroids in leprosy. Lepr Rev 52: 293–298.
-
2.
Croft RP , Nicholls PG , Richardus JH , Smith WC , 2000. The treatment of acute nerve function impairment in leprosy: Results from a prospective cohort study in Bangladesh. Lepr Rev 71: 154–168.
-
3.
Kiran KU , Stanley JN , Pearson JM , 1985. The outpatient treatment of nerve damage in patients with borderline leprosy using a semi-standardized steroid regimen. Lepr Rev 56: 127–134.
-
4.
Walker SL et al.; Erythema Nodosum Leprosum International STudy Group 2017. A leprosy clinical severity scale for erythema nodosum leprosum: An international, multicentre validation study of the ENLIST ENL Severity Scale. PLoS Negl Trop Dis 11: e0005716.
-
5.
Sardana K , Khurana A , Bhushan P , Sardana K & Khurana A Jopling’s Handbook of Leprosy. 7th ed. New Delhi, India: CBS, 311–321.
-
6.
Croft RP , Nicholls PG , Richardus JH , Smith WCS , 2000. The treatment of acute nerve function impairment in leprosy: Results from a prospective cohort study in Bangladesh. Lepr Rev 71: 154–168.
-
7.
van Brakel WH , Khawas IB , 1996. Nerve function impairment in leprosy: An epidemiological and clinical study–Part 2: Results of steroid treatment. Lepr Rev 67: 104–118.
-
8.
Saunderson PA , Gebre S , Desta K , Byass P , Lockwood DN , 2000. The pattern of leprosy-related neuropathy in the AMFES patients in Ethiopia: Definitions, incidence, risk factors and outcome. Lepr Rev 71: 285–308.
-
9.
Lockwood DN , Darlong J , Govindharaj P , Kurian R , Sundarrao P , John AS , 2017. AZALEP a randomized controlled trial of azathioprine to treat leprosy nerve damage and type 1 reactions in India: Main findings. PLoS Negl Trop Dis 11: e0005348.
-
10.
Jitendra SSV , Bachaspatimayum R , Devi AS , Rita S , 2017. Azathioprine in chronic refractory erythema nodosum leprosum: A case report. J Clin Diagn Res 11: FD01–FD02.
-
11.
Duraes SM , Salles Sde A , Leite VR , Gazzeta MO , 2011. Azathioprine as a steroid sparing agent in leprosy type 2 reactions: Report of nine cases. Lepr Rev 82: 304–309.
-
12.
Lambert SM , Nigusse SD , Alembo DT , Walker SL , Nicholls PG , Idriss MH , Yamuah LK , Lockwood DN , 2016. Comparison of efficacy and safety of cyclosporine to prednisolone in the treatment of erythema nodosum leprosum: Two randomised, double blind, controlled pilot studies in Ethiopia. PLoS Negl Trop Dis 10: e0004149.
-
13.
Sena CB , Salgado CG , Tavares CM , Da Cruz CA , Xavier MB , Do Nascimento JL , 2006. Cyclosporine A treatment of leprosy patients with chronic neuritis is associated with pain control and reduction in antibodies against nerve growth factor. Lepr Rev 77: 121–129.
-
14.
Jesus JB , Sena CBC , Macchi BM , do Nascimento JLM , 2022. Cyclosporin A as an alternative neuroimmune strategy to control neurites and recover neuronal tissues in leprosy. Neuroimmunomodulation 29: 15–20.
-
15.
Narang T , Kamat D , Sardana K & Khurana A Jopling’s Handbook of Leprosy. 7th ed. New Delhi, India: CBS, 252–223.
-
16.
Saini C , Siddiqui A , Ramesh V , Nath I , 2016. Leprosy reactions show increased Th17 cell activity and reduced FOXP3+ Tregs with concomitant decrease in TGF-beta and increase in IL-6. PLoS Negl Trop Dis 10: e0004592.
-
17.
Vieira AP , Trindade MA , Pagliari C , Avancini J , Sakai-Valente NY , Duarte AJ , Benard G , 2016. Development of type 2, but not type 1, leprosy reactions is associated with a severe reduction of circulating and in situ regulatory T-cells. Am J Trop Med Hyg 94: 721–727.
-
18.
Costa MB , Hungria EM , Freitas AA , Sousa AL , Jampietro J , Soares FA , Stefani MM , 2018. In situ T regulatory cells and Th17 cytokines in paired samples of leprosy type 1 and type 2 reactions. PLoS One 13: e0196853.
-
19.
World Health Organization , 2023. Leprosy. Available at: https://www.who.int/news-room/fact-sheets/detail/leprosy. Accessed July 15, 2023.
-
20.
World Health Organization , 2021. Leprosy: Number of New Cases 2021. Available at: https://www.who.int/data/gho/data/indicators/indicator-details/GHO/number-of-new-leprosy-cases. Accessed July 5, 2024.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 4470 | 4470 | 141 |
| Full Text Views | 48 | 48 | 13 |
| PDF Downloads | 52 | 52 | 11 |