ABSTRACT
Rectal biopsy in 190 inpatients at a leprosy hospital in the Highlands of Papua New Guinea disclosed 16 patients with secondary amyloidosis. This represented 20% of the patients who had had polar lepromatous leprosy (L.L.) for more than 2 years. Patients with amyloidosis characteristically had either a history of recurrent attacks of erythema nodosum leprosum (E.NH) reactions or chronic trophic ulcers. Levels of the serum component (protein SAA) antigenically related to the amyloid fibril protein AA were monitored, at varying intervals for three months, in lepromatous patients with E.N.L. reaction. The SAA levels rose during E.N.L. reactions in parallel with the neutrophil count. SAA occurred with greatest frequency among patients with LH, while most non-lepromatous patients with detectable SAA had chronic trophic ulcers. The correlation between raised neutrophil count and elevated SAA concentration, observed in this and other studies, suggests that neutrophils are associated with the production of SAA.
Subject(s)
Humans , Amyloidosis/etiology , Amyloidosis/blood , Leukocyte Count , Erythema Nodosum/complications , Erythema Nodosum/etiology , Leprosy/complications , Leprosy/blood , Leukocytosis/blood , RecurrenceABSTRACT
1- Tuberculin (Mantoux) and lepromin (Dharmendra) tests have been carried out among leprosy patients and normal and tuberculous controls in Malaya and Singapore. 2- Leprosy patients were found to have a much lower positive Mantoux rate than the normal population, although this difference was more marked in children than in adults. In Singapore, the figure among adults with leprosy approached that of the normal population. 3- Children with leprosy were found to respond to BCG vaccination, giving a Mantoux conversion rate very little lower than that found in normal children. 4- It is suggested that leprosy infects a selected population, consisting of Mantoux negatives. That is, tuberculosis infection may give some protection against leprosy. On the other hand, evidence is produced which demonstrates that tuberculosis is readily superimposed on existing leprosy. 5- The conversion to a Mantoux positive state appears to be the essential feature, not the positive lepromin response, that may result from such vaccination. This latter response, it is suggested, is nonspecific.