Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/28952
Title: Clinical, immunological and histological aspects of an uncommon type II reaction in patients with lepromatous leprosy
Authors: Esquenazi, Danuza
Moreira, A. L.
Miranda, A.
Nery, J. A. C.
Alvarenga, F. F.
Sarno, Euzenir Nunes
Pereira, G. M. B.
Affilliation: Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Micobacterioses. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Departamento de Patologia e Laboratórios. Rio de Janeiro, RJ, Brasil.
Memorial Sloan-Kettering Cancer Center. Department of Pathology. New York, NY, USA.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Micobacterioses. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Micobacterioses. Rio de Janeiro, RJ, Brasil.
Universidade do Estado do Rio de Janeiro. Departamento de Patologia e Laboratórios. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Micobacterioses. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Micobacterioses. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Departamento de Patologia e Laboratórios. Rio de Janeiro, RJ, Brasil.
Abstract: This study reports three cases of an unusual leprotic reaction characterized by superficial bullous ulcerative cutaneous lesions associated with high fever, malaise and oedema in patients with leprosy. Two patients responded to thalidomide treatment, with regression of the symptoms and skin ulcers. The third patient responded to thalidomide plus prednisone. Analysis of the ulcerated skin lesions showed dermal oedema with mononuclear cell infiltrate enriched for gammadelta-positive T lymphocytes and an increased number of Mycobaterium leprae bacilli within capillary endothelium. In contrast, gammadelta+ cells were decreased in or absent from the blood. Tumour necrosis factor-alpha and interleukin-6 were raised in the serum of the patients at the onset of the reaction. After the episode, cytokine levels and the percentage of gammadelta+ cells in the blood returned to normal. These cases characterize an uncommon leprotic reaction with clinical similarities to type II reaction and may indicate a significant role for gammadelta+ T cells in its pathogenesis.
Keywords: lepromatous leprosy
type II reaction
immunological aspects
clinical aspects
histological aspects
keywords: Hanseníase Virchowiana
Aspectos clínicos
Aspectos imunológicos
Aspectos histológicos
reação tipo 2
Issue Date: 2008
Publisher: Wiley
Citation: ESQUENAZI, Danuza; et al. Clinical, immunological and histological aspects of an uncommon type II reaction in patients with lepromatous leprosy. Clinical and Experimental Dermatology, v.33, p.294-297, 2008.
DOI: 10.1111/j.1365-2230.2007.02654.x
ISSN: 0307-6938
Copyright: restricted access
Appears in Collections:IOC - Artigos de Periódicos

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