RESUMO
The records of ten patients with Lucio's phenomenon showed clinical and histopathological changes similar to those described by others. Lucio's phenomenon is a syndrome distinct from erythema nodosum leprosum as indicated by an absence of fever, leukocytosis and tenderness, a failure to respond to thalidomide, and a restriction to patients with diffuse nonnodular lepromatous leprosy. Lymphopenia associated with splenomegaly in three patients and glomerulonephritis in one patient were unexpected findings of unknown relevance.
Assuntos
Hanseníase/patologia , Adulto , Dapsona/efeitos adversos , Dapsona/uso terapêutico , Eritema Nodoso/induzido quimicamente , Feminino , Humanos , Isquemia , Hanseníase/complicações , Hanseníase/tratamento farmacológico , Hanseníase/imunologia , Linfopenia/etiologia , Masculino , Pessoa de Meia-Idade , Necrose , Estudos Retrospectivos , Pele/irrigação sanguínea , Talidomida/uso terapêuticoAssuntos
Hanseníase/imunologia , Anticorpos Antibacterianos , Antígenos de Bactérias , Autoanticorpos/análise , Humanos , Imunidade Celular , Imunoglobulinas/análise , Imunoterapia , Antígeno de Mitsuda , Hanseníase/classificação , Hanseníase/diagnóstico , Hanseníase/terapia , Mycobacterium leprae/imunologiaRESUMO
The frequencies of distribution of 25 histocompatibility antigens were determined in 92 Mexican patients with leprosy and compared with those in 315 Mexicans who did not have the disease. No statistically significant differences were found between the patients and the controls in regard to histocompatibility antigens, and subgroups with a significant difference could not be identified by division of the patients according to the density of Mycobacterium leprae or the presence or absence of cell-mediated immunity directed against antigens of M. leprae.
Assuntos
Antígenos HLA/análise , Antígenos de Histocompatibilidade/análise , Hanseníase/imunologia , Epitopos , Humanos , Hanseníase/classificação , MéxicoRESUMO
Immunologic responses were measured in 46 patients with lepromatous leprosy. These patients were not distinguishable from controls on the basis of responses to soluble intradermal antigens, sensitization to contactants, peripheral blood T- and B-cell percentages, in vitro lymphocyte responses to a mitogen, or the prevalence of autoantibodies. Generalized immunologic abnormalities in patients with lepromatous leprosy are neither predisposing causes nor necessary accompaniments of lepromatous leprosy, but are probably remote sequellae of the illness. By implication, the generalized immunologic abnormalities reported in other diseases are likely to be remote sequellae of the particular illness.
Assuntos
Hanseníase/imunologia , Adulto , Idoso , Antígenos , Autoanticorpos , Linfócitos B/imunologia , Dermatite Atópica/induzido quimicamente , Dermatite de Contato/etiologia , Dinitroclorobenzeno , Dinitrofluorbenzeno , Feminino , Humanos , Lectinas/farmacologia , Antígeno de Mitsuda/farmacologia , Hanseníase/classificação , Hanseníase/genética , Contagem de Leucócitos , Ativação Linfocitária , Masculino , Pessoa de Meia-Idade , Pele/imunologia , Linfócitos T/imunologiaRESUMO
Biopsy specimens of apparently uninvolved skin from 34 patients with lepromatous leprosy were studied histologically. Bacilli were found in 30 of 31 specimens from clinically polar or near-polar lepromatous patients but not in the three from nonpolar patients. A predominantly perivascular distribution of infiltrate and bacilli is consistent with a hematogenous spread of infection. Subclinical, diffuse lepromatous leprosy is found in patients with nodular lesions and may precede the development of nodules. Study of apparently uninvolved skin may be helpful in classifying patients, in interpreting immunologic responses, and in elucidating the natural history of the illness.
Assuntos
Hanseníase/patologia , Pele/patologia , Adulto , Feminino , Humanos , Hanseníase/classificação , Hanseníase/microbiologia , Masculino , Pessoa de Meia-Idade , Pele/microbiologiaRESUMO
We report 32 patients with erythema nodosum leprosum (ENL). Twenty-two patients developed ENL before beginning chemotherapy. The recognition that ENL in the absence of chemotherapy is not an uncommon event is of importance, not simply as a fact in and of itself, but because this observation raises provocative questions when placed in the context of current ideas concerning ENL. ENL should be regarded as a manifestation of leprosy, not necessarily as a complication of its therapy.
Assuntos
Eritema Nodoso/etiologia , Hanseníase/complicações , Sulfonas/efeitos adversos , Adolescente , Adulto , Idoso , Eritema Nodoso/diagnóstico , Eritema Nodoso/imunologia , Eritema Nodoso/patologia , Feminino , Humanos , Hanseníase/classificação , Hanseníase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Sulfonas/uso terapêuticoRESUMO
Immunoglobulin deposits were detected in ten of 13 biopsy specimens from apparently uninvolved skin of patients with lepromatous leprosy. There were deposits of IgM at the dermoepidermal junction in the skin of five patients, and deposits of IgM along the dermal collagen and elastic fibers in the skin of the other five. The deposits were eluted with acid buffers and high molarity salt solution. Circulating IgG antibodies to intercellular substance of epithelial cells, similar to those present in pemphigus vulgaris, were found in 25% of patients with lepromatous leprosy who were studied. These antibodies appeared to be different from the skin-bound immunoglobulin deposits.