Male gonads in leprosy--a clinico-pathological study.

Sixty male leprosy patients (mean age 27.2 +/- 5.04 years) selected at random, were studied for gonadal involvement with the mean duration of illness 4.17 +/- 3.27 years. Only lerpomatous and borderline leprosy cases developed testicular and epididymal changes. Testicular pain and/or swelling (lepromatous 62.5%, borderline 30%) was the main presenting feature. Altered sexual function was observed in 34(56.6%) cases, and 11 patients revealed altered sexual hair pattern. Gynecomastia was seen in 9 cases. Reduced testicular size along with its soft feeling was present in 25% of cases while no testicular sensation was felt in 8 (13.3%) cases, and impaired testicular sensation in 9 (15%) of them. Spermogram revealed azoospermia in 19 (35%) and oligospermia in 16 (26.6%) cases. Histo-pathology revealed evidences of leprous pathology irrespective of testicular size, semen picture and clinical manifestations. There was marked variation in histopathological findings in testes and hence it was difficult to categorise them into vascular, interstitial and obliterative phase.

Autonomic neuropathy in leprosy.

21 patients of borderline lepromatous and lepromatous leprosy of both sexes were taken for study after exclusion of autonomic disorders. Autonomic functions pertaining to cardiovascular and genital system were carried out. Five healthy volunteers served as controls. Autonomic function tests indicate definite involvement of cardiovascular and genital system. The incidence of autonomic neuropathy in 21 patients studied was ranging from 14.3 to 57% for various tests. There is involvement of parasympathetic system (vagus nerve) which occurred early and more common than sympathetic. The sympathetic damage is always associated with parasympathetic damage. The severity of autonomic neuropathy is found to be high in leprosy of longer duration. Autonomic neuropathy widely occurs in leprosy as in diabetes mellitus.

Hormone profile in lepromatous leprosy. A preliminary study.

In a preliminary study, 11 male patients with lepromatous leprosy were evaluated with regard to endocrinopathy and hormonal status. Basal circulating hormone levels were estimated with a view to correlating the biochemical findings and clinical features. Thyroid hormones T3 and T4, Free Thyroxine Index (FTI), TSH, and cortisol were within normal limits, indicating that further study of these hormones would not be worthwhile. The finding of elevated levels of prolactin as well as the gonadotrophins LH and FSH, however, promises to yield more valuable information if studied in greater detail in a larger group of patients.

Evaluation of male gonadal function in leprosy

Impotency, sterility, loss of libido, loss of sexual hair and gynecomastia are well documented in patients suffering from leprosy. They occur with greater frequency in lepromatous leprosy as compared to dimorphous and tuberculois types.