Is there a relation between hemicrania continua and leprosy?

The association of hemicrania continua and leprosy has been described in 2008. This relation can be causal or casual. Hemicrania continua is a strictly unilateral, moderate to severe, continuous, indomethacin-responsive primary headache with autonomic cranial symptoms and leprosy is an usual cause of peripheral neuropathy. Prevalence has fallen in the past years, but transmission continues and leprosy remains a public health problem. The objective of this study is to report one case of headache fulfilling the IHS criteria for HC, presented during the course of leprosy. A 61 years old woman started hypo and hiperpigmented lesions with impaired sensation to touch on right side of face (malar). She had biopsy in facial lesion and histopathology compatible with a borderline leprosy form. At the same time, she reported new headaches, daily and continuous, without pain-free periods, unilateral (which were located in the same side of the leprosy lesion in face), throbbing and severe (VAS = 8) with ipsilateral conjuntival injection and lacrimation that improved with indomethacin. We hypothesize that the local injury on the face of this patient predisposes a mechanism of central sensitization, resulting in trigeminal autonomic cephalgia. Relation between trigemino-autonomic cephalalgias and leprosy provides insights into craniofacial pain mechanisms.

A case study in Hansen's disease acquired after heart transplant.

Hansen's disease, leprosy, is a chronic infectious disease caused by the acid-fast bacillus Mycobacterium leprae. There are multiple forms of the disease ranging from the relatively benign to the progressive, malignant lepromatous leprosy. There is effective antimicrobial treatment available that is capable of curing the disease. We report the case of a post heart transplant patient acquiring Hansen's disease.

Estimating the relative recurrence risk ratio using a global cross-ratio model

The relative recurrence risk ratio lambdaR (and particularly the sibling recurrence risk ratio, lambdaS) is often of interest to those wanting to quantify the genetic contribution towards risk of disease or to discriminate between different genetic models. However, estimating lambdaR for complex diseases for which genetic and environmental risk factors are both involved is not straightforward. Ignoring environmental factors may lead to inflated estimates of lambdaR. We present a marginal model which uses a copula function to model the association in cumulative incidence rates between pairs of relatives. This model is applicable to present-state data and allows estimation of risk of disease in a pair of relatives (and hence lambdaR), given measured environmental covariates. We apply the model to leprosy among sibling pairs from the Karonga district, Malawi. If risk factors are ignored, the apparent lambdaS in this population is over 3. Accounting for known nongenetic risk factors reduces it to just under 2.

Locally acquired Hansen's disease in north Queensland.

Hansen's disease (leprosy) is rare in Australia and usually imported from endemic areas. We report a 23-year-old white male with multibacillary leprosy who had lived all his life in North Queensland and initially appeared to have no risk factors. However, historical records revealed his grandfather to have been infected; because of stigma, this was unknown to the patient. As Hansen's disease has an incubation period of years, isolated cases may still occur as a result of previous endemicity in Queensland.

The dot-ELISA test for the detection of anti-PGL-1 IgM in leprosy patients and their contacts

Since dot-ELISA has recently been reported to be a sensitive, simple and method, we have compared it with the conventional microplate ELISA method. Sera of 124 leprosy patients, 136 household and professional contacts, and 92 controls were tested for a antibodies against a Mycobacterium leprae antigen using dot-ELISA on nitrocellulose membrane filters and microplate ELISA. The sensitive of the techniques was similar for multibacillary patients, but dot-ELISA was less sensitive for paucibacillary patients although it was more specific (100%) than ELISA (93,4%). Of 21 household contacts that gave a response by ELISA, 3 were also positive by dot-ELISA; one of these 3 developed indeterminate leprosy 12 months later and the other was diagnosed as borderline lepromatous after 28 months. These data indicate that dot-ELISA has a high spedificity and can be a useful tool in field evaluation

Hanseníase: contribuiçao aos parâmetros da classificaçao

O autor comprovou que a adoçao dos critérios de Ridley-Jopling, simultaneamente com os parâmetros de classificaçao de Madri, contribuiu no Brasil, a partir de 1970, para o aumento do número de diagnósticos de hanseníase dimorfa atingindo, as vezes, o percentual de 25 por cento. Os parâmetros de Ridley-Jopling permitiram classificarem subgrupos apenas 32 por cento dos dimorfos. Observou que os critérios de classificaçao de Madri nem sempre foram utilizados: a falta de informaçoes sobre o número e limites das lesoes cutaneas chegou a 45 por cento; a baciloscopia nao consta de 20 por cento dos prontuários; o teste de Mitsuda deixou de ser realizado em 48 por cento de uma das amostras; o exame histopatológico, apesar de mais laborioso, somente nao foi feito em 3,6 por cento dos casos

Epidemiologia: Parte 1. contagio familiar y extrafamiliar en lepra / Parte 2. Estudio de los convivientes que se encontraron enfermos de lepra en el periodo que va de 1946 a agosto de 1950 / Epidemiology: Part 1, I infect relative and extrarelative in leprosy.Part 2. Study of the convivientes that were patients of leprosy in the period that goes of 1946 to August of 1950

El estudio hecho en 272 enfermos del Sanatorio de Las Mercedes, muestra que en 178 casos(65,5%) el contagio fue familiar y que en 94 (34,5%) casos el contagio se produjo fuera de la familia. El hecho de que entre los miembros de la familia de un enfermo aparezca mayor numero de enfermos y que entre ellos se encuentran formas mas graves de lepra que entre los enfermos que adquirieron la lepra fuera de su familia, hace pensar que el contagio de la lepra necesita un contacto prolongado con el enfermo contagioso y de una predisposicion familiar hereditaria que favorezca el contagio. La incidencia de la lepra (en Costa Rica) entre los parientes del enfermo es del 6%. Este porcentaje puede aumentar con los futuros examenes de control. Se encontró positivos son responsables del contagio. El contagio entre parientes se realizo en el 70% cuando vivian en la misma casa y en el 30% cuando habitaban casas distintas.