Edema in leprosy: clinical and therapeutical aspects

Revista da Sociedade Brasileira de Medicina Tropical

Vieira, Leila M.M.¹  Nery, José A.C.¹  Salles, Ana Maria¹  Valentini, Attilio¹  Universidade Federal Fluminense, Niterói¹  Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brasil¹  Sarno, Euzenir N.¹  Fundação Oswaldo Cruz, Rio de Janeiro¹ 

关键词: Edema;    Leprosy;    Reaction;    Thalidomide;    Corticosteroids;    Pentoxifylline;    TNF;    IL-1;   

DOI  :  10.1590/S0037-86821999000200003

学科分类：农业科学（综合）

来源: Sociedade Brasileira de Medicina Tropical

【 摘 要 】

Edema, which is commonly described as a symptom of reactional states, may occur during the course of leprosy. Both diagnosis and adequate treatment measures are often difficult to achieve and failure to do so may result in permanent damage to the lower limbs. In a one-year follow-up study of leprosy patients - ten multibacillary and one paucibacillary - who had been submitted to a clinical protocol for diagnosis and pathological classification, a clinical pattern of localized and/or systemic edema was observed. Among these patients, five simultaneously presented other symptoms related to reactional states, 4 were diagnosed as Type I, and one as Type II. On the other hand, while three of the patients did not present reaction at the time when edema was diagnosed, they did develop some aspects of reactional disease later on (two had neuritis e one had Type I reaction). The edemas that preceded or were associated with reactional episodes showed clinical regression as a result of specific treatment against reactions (corticosteroids and/or pentoxifylline and/or thalidomide) in the absence of another treatment normally used for edemas. Although these data need to be confirmed by controlled studies, they strongly suggest that immunological mechanisms are involved in the physiopathology of edema in leprosy.

【 授权许可】

Unknown