ISSN: 2574-7800
Authors: Namisato M*
We must always be cautious about reactions that can cause severe, irreversible deformities when treating leprosy. We studied the clinical course of two patients with subpolar lepromatous leprosy. The first patient was newly diagnosed and the second had relapsed. The latter had drug resistance-related mutations to three drugs, diaminodiphenyl sulfone, rifampicin, and ofloxacin. Patient 1 had a heavy bacterial load and type 2 leprosy reaction (erythema nodosum leprosum) before starting chemotherapy. After 2 weeks of starting the chemotherapy, he developed a severe reversal reaction (RR), which sustained for approximately 6 months. The bacterial load of patient 2 was not as heavy as that of patient 1. He developed RR about 1.5 years after starting the chemotherapy and it was sustained for about 6 months. The severity of RR was lower than in patient 1. About 3 years after beginning the chemotherapy, when their bacterial loads had greatly decreased, both patients developed RR again, with nerve trunk injury. Thereafter, their leprosy was completely cured without any residual motor dysfunction. The appropriate length of the follow-up period should be further investigated.
Keywords: Cholinergic Anti-Inflammatory Pathway; Proinflammatory Cytokines; Sepsis; STAT3 Inhibitor; NF-Κb Inhibitor
