Immune response in patients diagnosed with leprosy
Keywords:
immune response, Hansen’s disease, reactional states, erythema nudosum leprosumAbstract
Introduction: Leprosy is a floridly expressed entity with frequent involvement of the cutaneous integument and peripheral nerves due to the predisposition of Mycobacterium leprae to these structures. Leprosy reactions may appear during the course of the disease. These interrupt the usual chronic course and the clinical stability of patients suffering from the disease.
Objective: To characterize the reactional states of leprosy.
Materials and methods: A descriptive study was carried out from January 2019 to September 2022 in patients who attended the Provincial Leprosy Clinic at the Clinical Surgical University Hospital Comandante Faustino Pérez Hernández, in Matanzas. The universe consisted of 8 patients who presented reactional states in the aforementioned stage. The variables, collected from the clinical records, were: age, sex; classification of leprosy according to Ridley-Jopling, type of reactional state, clinical form and time of onset.
Results: The highest frequency was between 50 and 64 years, with 50%. The male sex represents 62.5%. Lepromatous leprosy prevalence was shown in 62.5%. The type II reaction and severe forms were the most frequent with 62.5% and 75% respectively. There was predominance of leprosy reactions during and after treatment without differences between them, with 37.5%.
Conclusions: The type II reaction with severe forms of presentation was predominant in male patients represented in the age group of 50 to 64 years. The predominant clinical form in these events was the lepromatous one.
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2. Bolognia JL, Schaffer JV, Cerroni L. Dermatología [Internet]. 4ª ed. Barcelona: Elsevier; 2018 [citado 17/10/2022]. Disponible en: https://edimeinter.com/catalogo/novedad/dermatologia-4a-edicion-2018/
3. Inzunza-Cervantes G, García-Tinoco RM, Ahumada-Félix SR, et al. Lepra lepromatosa con reacción tipo II, panorama de una enfermedad milenaria en el siglo XXI: Presentación de caso. Rev Med UAS [Internet]. 2021 [citado 12/10/2022];11(2):136-47. Disponible en: http://hospital.uas.edu.mx/revmeduas/articulos/v11/n2/lepra.html
4. Lee Delphine J, Rea Thomas H, Modlin Robert L. Chapter 186. Leprosy. Fitzpatrick's dermatology in general medicine [Internet]. 8ª ed. New York: McGraw Hill; 2012 [citado 12/10/2022]. Disponible en: https://accessmedicine.mhmedical.com/content.aspx?bookid=392§ionid=41138913
5. Organización Mundial de la Salud. Lepra/Enfermedad de Hansen: manejo de reacciones y prevención de discapacidades: Orientación técnica [Internet]. Ginebra: Organización Mundial de la Salud; 2021 [citado 28/10/2022]. Disponible en: https://apps.who.int/iris/handle/10665/340710
6. Falabella Falabella R, Victoria Chaparro J, Barona Cabal MI. Fundamentos de Medicina. Dermatología [Internet]. Medellín: CIB Fondo Editorial; 2017 [citado 12/10/2022]. Disponible en: https://booksmedicos.org/tag/fundamentos-de-medicina-dermatologia-8a-edicion-pdf-gratis/
7. García Leyva Y, Brito Chávez M, González González K. Lepra lepromatosa y eritema nudoso leproso: evolución natural. Folia Dermatol Cuban [Internet]. 2020 [citado 09/10/2022];14(1):e192. Disponible en: https://revfdc.sld.cu/index.php/fdc/article/view/192
8. Mir García YG, Ferrá Torres TM, Atrio Mouriño N, et al. Comportamiento de los estados reaccionales de la lepra en la provincia Camagüey. Cuba. Fontilles, Rev Leprol [Internet]. 2017 [citado 20/10/2022];31(3):177-97. Disponible en: https://pesquisa.bvsalud.org/portal/resource/%20es/ibc-170809
9. Mir García YG, Hernández Rodríguez H, Atrio Mouriño N, et al. Lepra lepromatosa con inicio neural puro. A propósito de un caso. Fontilles, Rev Leprol [Internet]. 2018 [citado 15/10/2022];31(5):341-7. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/ibc-175728
10. Muñoz Molina L, Constanza Corrales L, Hernández Barbosa R, et al. La lepra: patología con conciencia histórica. Enf Inf Microbiol [Internet]. 2013 [citado el 12/10/2022];33(1):32-43. Disponible en: https://www.medigraphic.com/cgi-bin/new/resumen.cgi?IDARTICULO=40013
11. Wankhade VH, Debnath P, Singh RP, et al. A retrospective study of the severe and uncommon variants of erythema nodosum leprosum at a tertiary health center in central India. Int J Mycobacteriol [Internet]. 2019 [citado 12/10/2022];8(1):29-34. Disponible en: https://journals.lww.com/ijmy/Fulltext/2019/08010/A_Retrospective_Study_of_the_Severe_and_Uncommon.5.aspx
12. Dirección de Registros Médicos y Estadísticas de Salud. Anuario estadístico de Salud 2021 [Internet]. La Habana: Ministerio de Salud Pública; 2022 [citado 17/11/2022]. Disponible en: https://www.researchgate.net/publication/365872415_Anuario_estadistico_de_Salud_2021#read
13. Mir García YG, Atrio Mouriño CN, Fernández Cervantes D, et al. Caracterización clínica-epidemiológica de pacientes con reacciones lepróticas en la provincia Camagüey, 1999-2020. Fontilles, Rev Leprol [Internet]. 2021 [citado 24/10/2022];33(1):33-50. Disponible en: https://www.leprosy-information.org/media/1150/download
14. Mir García YG, Atrio Meriño N, Fernández Cervantes D. Lepra y leprorreacciones su abordaje en Atención primaria de Salud [Internet]. La Habana: I Jornada Virtual de Resultados Científico-Técnicos INHEM 2021; 2021 [citado 23/10/2022]. Disponible en: https://jorcienciainhem2021.sld.cu/index.php/jorcienciainhem/2021/paper/viewPaper/65
15. Samudio-Domínguez GC, Espínola-Espínola RB. Reacciones lepromatosas en pacientes adultos y pediátricos en un centro de referencia. Programa Nacional de Lepra, Paraguay. Rev Nac [Internet]. 2016 [citado 23/10/2022];8(2):4-18. Disponible en: http://scielo.iics.una.py/scielo.php?pid=S2072-81742016000200004&script=sci_arttext
16. Ferrá-Torres TM, Florat-Gutiérrez DC, Rodríguez-del-Valle K. Factores antropológicos socio-demográficos en la incidencia de lepra. Arch Méd Camagüey [Internet]. 2022 [citado 16/10/2022];26:e8853. Disponible en: http://scielo.sld.cu/scielo.php?pid=S1025-02552022000100070&script=sci_arttext
17. Klein Bisinella Dias B, Da Costa Boamorte Cortela D, Cordeiro TdS, et al. Análisis temporal de la incidencia de lepra y sus reacciones en una región hiperendémica. Res Soc Dev [Internet]. 2020 [citado 16/10/2022];9(10):e8559109145. Disponible en: https://rsdjournal.org/index.php/rsd/article/view/9145
18. Cáceres Pallavidino GH, Antinori M, Baleirón MdC, et al. Brotes reaccionales de la enfermedad de hansen en el dispensario dermatológico “Hersilia Casares de Blaquier” de la ciudad de Corrientes. Rev Posgrado VIa Cátedra Med [Internet]. 2010 [citado 21/10/2022];(200):10-6. Disponible en: https://studylib.es/doc/297101/brotes-reaccionales-de-la-enfermedad-de-hansen-en-el-disp...
19. Montes AM, Orozco B, Gaviria M. Lepra dimorfa en estado reaccional tipo 1 y 2. Rev asoc colomb dermatol cir dematol [Internet]. 2009 [citado 23/10/2022];17(1):51-3. Disponible en: https://revista.asocolderma.org.co/index.php/asocolderma/article/view/151
20. de Castro Pereira Chaves AF, de Araújo OD, da Costa Leite Sousa EC, et al. Magnitude dos episódios reacionais na hanseníase em serviço ambulatorial especializado. Hansen Int [Internet]. 2022 [citado 10/12/2022];47:1-12. Disponible en: https://periodicos.saude.sp.gov.br/hansenologia/article/view/37318
21. Alemán Martínez T, De León Gutiérrez OE, Hernández Alemán DM. Comportamiento del diagnóstico, las reacciones leprosas y las discapacidades por lepra en el municipio Chambas. La Habana: XXXII Jornada Nacional de Lepra; 2022 [citado 20/10/2022]. Disponible en: https://lepra2022.sld.cu/index.php/lepra/2022/paper/viewPaper/7
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