RESUMO
It is well known that reactions are commonplace occurrences during the course of leprosy disease. Stigmatization may even be attributable to reactions which are also responsible for the worsening of neural lesions. A cohort of 162 newly-diagnosed baciloscopically positive patients from the Leprosy Care Outpatient Clinic of the Oswaldo Cruz Foundation (FIOCRUZ) was selected for this study. While 46% of the multibacillary (MB) patients submitted to the 24 fixed-dose multidrug therapy (MDT) regimen suffered reactions during treatment, it was found that all MBs were susceptible and that constant attention and care were required at all times. Fourteen per cent were classified as BB, 52% as BL, and 33% as LL. None of the variables under study, such as, sex, age, clinical form, length of illness, length of dermatological lesions, baciloscopic index (BI), or degree of disability proved to be associate with reaction among the patients studied. Reversal Reaction (RR) occurred in 45%, and Erythema Nodosum Leprosum (ENL) occurred in 55%. Among BB patients who developed reactions (15 patients), 93% presented RR; while among the LL patients who developed reactions (34 patients), 91% presented ENL. Likewise, ENL was very frequent among those with disseminate lesions, while RR was most often observed in patients with segmentary lesions. RR was also most likely to occur during the initial months of treatment. It was demonstrated that the recurrence rate of ENL was significantly higher than that of RR. Neither grade of disability nor BI was shown to be associated with RR and ENL reaction. However, the RR rate was significantly higher among patients showing BI 3
Assuntos
Masculino , Feminino , Humanos , Criança , Adulto , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/dietoterapia , Hanseníase/dietoterapia , Quimioterapia CombinadaAssuntos
Benzilaminas/farmacocinética , Benzilaminas/farmacologia , Benzilaminas/uso terapêutico , Camundongos Endogâmicos BALB C , Dapsona/farmacologia , Dapsona/uso terapêutico , Hanseníase/dietoterapia , Hanseníase/terapia , Mycobacterium leprae , Mycobacterium leprae/crescimento & desenvolvimento , Rifampina/farmacologia , Rifampina/uso terapêuticoRESUMO
1) Se han tratado 29 casos de atrofia muscular de las manos en enfermos de lepra y se ha observado que 18 casos mejoraron clinicamente por el tratamiento con Vitamina E. 2) Se observo que las atrofias presentadas por los casos de lepromatosos difusos son los mas dificiles de modificar, al contrario de lo que pasa con los casos de forma indiferenciada. Se supone que las atrofias son mas rebeldes en la forma lepromatosa difusa porque muchos de estos casos son la resultante de una forma indiferenciada de evolucion prolongada. 3) La duracion de la enfermedad influye mucho en la reversibilidad de la atrofia. La mejoria es tanto mayor cuanto mas reciente es la enfermedad.