Insuficiência hepática na hanseníase devida a amiloidose / Hepatic Insufficiency in leprosy had the amyloidosis

ABSTRACT

A case of hanseniasis with uncommonly severe secondary amyloidosis is reported and discussed. Clinical, laboratory and post-mortem findings show large involvement of the liver and hepatic deficiency, the principal cause of death. Hepatic deficiency with portal hypertension has been described in primary amyloidosis, but in the secondary type, as in this case, it has only been reported reported once, by Manzi et al (1971). It is attributed to protracted long term hanseniasis, hansenic reactions of the erythema nodosum type and osteomyelitis related to plantar ulcerations, all those conditions leading to an excess of antigenic stimulation and debilitation, of the humoral response. Althought 25 por cento of deaths due to hanseniasis in the West are caused by amuloidosis of the kidneys causing a nephrotic syndrome, in the case it did not lead to serious renal dysfunction