RESUMO
This case report depicts a case of histopathologically confirmed polar lepromatous (LL) leprosy with a bacterial index of 4+. He experienced recurrent episodes of erythema nodosum leprosum (ENL) in the first 5 years after diagnosis. Skin smears became negative after 6 years of dapsone monotherapy and have remained negative since that time. At 23 years after diagnosis, the patient had developed cataracts and underwent intracapsular cataract extractions with broad-based iridectomies. In one of the iris specimens, histopathologic examination revealed a focal granuloma composed of epithelioid cells. Subsequently a lepromin skin test showed a positive Mitsuda reaction with a borderline tuberculoid histopathology. This clearly illustrates the immunological upgrading of a polar lepromatous patient, perceived first in the iris tissue.
Assuntos
Eritema Nodoso/complicações , Iridociclite/complicações , Hanseníase Virchowiana/complicações , Adulto , Eritema Nodoso/patologia , Humanos , Iridociclite/patologia , Hanseníase Virchowiana/patologia , MasculinoAssuntos
Extração de Catarata , Catarata/etiologia , Iridociclite/complicações , Hanseníase/complicações , Idoso , Infecções Oculares Bacterianas/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Estudos Retrospectivos , Resultado do Tratamento , Acuidade VisualAssuntos
Catarata/etiologia , Catarata/terapia , Cegueira/etiologia , Cegueira/terapia , Cirurgia Geral , Congresso , Doenças da Túnica Conjuntiva/complicações , Hanseníase/complicações , Hanseníase/reabilitação , Hanseníase/terapia , Iridociclite/complicações , Iridociclite/terapia , Morbidade , Olho/fisiopatologia , Olho/inervação , Olho/irrigação sanguínea , Olho/patologia , Síndromes do Olho Seco/complicações , Síndromes do Olho Seco/terapiaRESUMO
The intraocular pressures of a total of 286 eyes of patients with lepromatous and borderline lepromatous leprosy who never had regular ophthalmological care or local eye treatment were measured. The patients were categorised according to the type of leprosy they had, and the eyes were categorised as without or with chronic plastic iridocyclitis. In patients with lepromatous and borderline lepromatous types of leprosy the intraocular pressure was significantly lower in eyes with chronic plastic iridocylitis 10.1 (3.6) mmHg than in both unaffected eyes 11.0 (3.2) mmHg and control eyes 13.5 (2.5) mmHg. It has been shown that chronic plastic iridocyclitis which remains untreated for years results in a lower intraocular pressure than normal.