RESUMEN
Whether Mycobacterium leprae transmits from placenta to fetus remains unknown. We describe the case of a pregnant woman with untreated histoid leproma. Although her newborn was healthy, laboratory examination revealed intact M. leprae present in the placenta, suggesting that the placental barrier might prevent vertical dissemination of M. leprae.
Asunto(s)
Lepra/diagnóstico , Lepra/microbiología , Mycobacterium leprae/aislamiento & purificación , Placenta/microbiología , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/microbiología , Antituberculosos/uso terapéutico , Biopsia , China/epidemiología , Femenino , Humanos , Lepra/epidemiología , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Resultado del Embarazo , Piel/patología , Resultado del Tratamiento , UltrasonografíaRESUMEN
Three pregnant lepromatous armadillos along with the three sets of four fetuses and their placentae were studied histopathologically. Mycobacterium leprae were present in the decidual tissue, trophoblastic cells which line the chorionic villi, and in the cells that form the internal structure of the villi. Acid-fast organisms were also seen in the spleens of three fetuses. Congenital infection is clearly possible in leprosy in the armadillo and may also occur in humans.
Asunto(s)
Lepra/congénito , Animales , Armadillos , Femenino , Feto/patología , Lepra/microbiología , Lepra/patología , Lepra/transmisión , Intercambio Materno-Fetal , Placenta/microbiología , Placenta/patología , Enfermedades Placentarias/etiología , Enfermedades Placentarias/microbiología , EmbarazoRESUMEN
Eighty-one placentae from women with leprosy and 17 placentae from healthy controls were subjected to a detailed macroscopic, light microscopic, ultrastructural, immunopathological, microbiological and biochemical study. The placental morphology and immunohistology were normal, and there was no morphological evidence of infection of the placenta due to M. leprae. No acid-fast bacilli or acid-fast bacillary granules were seen on light microscopy of any of the placentae from leprous women, although homogenates from two out of seven placentae from women with very active lepromatous leprosy contained acid-fast bacilli in very small numbers. The small placental size of women with leprosy, most marked in those with lepromatous leprosy, appears to be due to a decrease in placental cell size, rather than to a reduced number of cells in the placenta. It is postulated that the small placenta and reduced fetal birth weight observed in lepromatous leprosy are a consequence of depressed maternal immune reactivity.