Case Report: Successful Outcome of Primary Infertility with Multidrug Therapy in a Long-Standing Case of Hypogonadism Resulting from Lepromatous Leprosy: Shattering the Dogma of Irreversible Infertility in Leprosy
We present a case of primary infertility with features of hypogonadism in a male patient with lepromatous leprosy who had remained undiagnosed for 3 years. On investigation, azoospermia and deranged gonadotropin levels with normal serum testosterone were noted and the patient was initiated on multibacillary–multidrug therapy with the primary aim of treating the disease. Although the cutaneous lesions improved within 6 weeks, remarkably, infertility was reversed in 2 months—with concomitant normalization of luteinizing hormone, follicle stimulating hormone, and sperm count—an outcome that was unexpected. While reiterating leprosy as a cause of infertility, considered to be an uncommon cause among endocrinologists, we also discuss the probable mechanism for the efficacy of the WHO multidrug therapy in what seemed to be an irreversible outcome of advanced lepromatous leprosy.
Address correspondence to Kabir Sardana, Department of Dermatology, Venereology and Leprosy, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, India. E-mail: email@example.com