Six cases of leprosy associated with allogeneic hematopoietic SCT (original) (raw)

Histopathological changes in leprosy and its correlation with IHC markers

International Journal of Clinical and Diagnostic Pathology

Leprosy is a chronic granulomatous disease. It involves the psychological, socioeconomic dimensions of an individual. Histopathology is considered as an accurate method for diagnosing leprosy. Immunity is largely T-cell mediated, whereas deficiency of T-cells causes lepromatous leprosy. The relative proportion of T and B lymphocytes were studied using CD3 and CD20 immunohistochemistry markers (IHC). A Retrospective, prospective and observational study was carried from August 2016 to July 2019. The cases were divided based on histopathological findings. IHC markers CD3 was used to study T cell whereas CD20 was used to study B-cells. As per Ridley Jopling classification maximum cases belonged to indeterminate forms. Bacillary load of 4+ and above was seen in lepromatous leprosy. CD3 showed strong positivity in all types whereas CD20 showed more focal positive staining for lepromatous leprosy than tuberculoid and indeterminate forms.

LOCALIZED LEPROMATOUS LEPROSY AND ITS RESPONSE TO CHEMO-IMMUNOTHERAPY

International Journal of Dermatology, 1994

Background. This is an unusual presentation of lepromatous leprosy (ll) in a young boy, 12 years of age. The study forms part of a large scale immunotherapeutic trial with Mycobacterium w (M.w) antileprosy vaccine. The trial is being conducted in two major hospitals in New Delhi, India.Materials and Methods. This patient presented with three lesions: one on each forearm and the third on the left leg. He was classified initially as borderline tuberculoid leprosy. Slit-skin smears and histopathology from the lesions proved the diagnosis to be lepromatous leprosy with a bacterial index (bi) 6+. The initial lepromin test was negative. The patient was treated with chemo-immunotherapy (standard multidrug therapy and immunotherapy with Mycobacterium w vaccine).Results. Investigations after 1 year (15 months) of multidrug therapy and three doses of vaccine, showed a remarkable fall in the bi from 6 to 0 in the lesions, a lepromin positivity of 5 mm, and a histological upgrading from lepromatous leprosy to borderline tuberculoid. Immunologic studies at 15 months revealed a good LTT response and high levels of cytokines, specifically IL-2 and IFN-γ.Conclusions. This report presents an LL patient with disease limited to a few sites. It stresses the importance of slit-smear and biopsy in all patients of leprosy, and it highlights the upgrading observed on administration of chemo-immunotherapy.

Leprosy in a renal transplant recipient: review of the literature

Transplant Infectious Disease, 2009

A 52-year-old male underwent living-related renal transplantation. He received prednisolone, azathioprine, and cyclosporine as immunosuppression protocol. Eleven years after transplantation, he developed pyrexia with multiple nodular lesions on his limbs, trunk, and face. Skin biopsy and smears showed the presence of numerous acid-fast bacilli with 5% sulfuric acid indicative of Mycobacterium leprae. He was initiated on multidrug therapy (MDT) including dapsone, clofazimine, and rifampicin. After 2 years of MDT, he developed new multiple erythematous, tender subcutaneous nodules in crops over his face and upper limbs. Skin biopsies and histopathological examination con¢rmed the diagnosis of type 2 lepra reaction or erythema nodosa leprosum. He was managed with an increase in the dose of prednisolone and thalidomide. He was continued on MDT. Leprosy is rarely seen in organ transplant patients. Leprosy may be recrudescent or may develop de novo several years after transplantation. Leprosy in a renal transplant recipient requires multidrug therapy (MDT) for a prolonged duration. We report on a patient with lepromatous leprosy presenting 11 years after renal transplantation. After 2 years of MDT he developed a type 2 lepra reaction, which was managed by increasing the dose of prednisolone and thalidomide. He was continued on MDT. We also reviewed the literature on leprosy and renal transplantation.

Leprosy in a patient infected with HIV

Practical neurology, 2016

A 60-year-old Nigerian man, who had lived in Europe for 30 years but had returned home frequently, presented with right frontalis muscle weakness and right ulnar nerve palsy, without skin lesions. Neurophysiology showed a generalised neuropathy with demyelinating features. Blood tests were positive for HIV, with a normal CD4 count. There was nerve thickening both clinically and on MRI. Nerve biopsy showed chronic endoneuritis and perineuritis (indicating leprosy) without visible mycobacteria. His neuropathy continued to deteriorate (lepra reaction) before starting treatment with WHO multidrug therapy, highly active antiretroviral therapy and corticosteroids. There are 10 new cases of leprosy diagnosed annually in the UK. Coinfection with HIV is rare but paradoxically does not usually adversely affect the outcome of leprosy or change treatment. However, permanent nerve damage in leprosy is common despite optimal therapy. Leprosy should be considered in patients from endemic areas who...

Lepromatous leprosy as a presenting feature of HIV

Indian Journal of Sexually Transmitted Diseases and AIDS, 2021

Various bacterial, mycobacterial and fungal opportunistic infections occur frequently in immunocompromised individuals, however, leprosy in retroviral disease is a relatively rare association. Hereby, we report a case of lepromatous leprosy that presented with clinical features mimicking other opportunistic infections and subsequently led to the diagnosis of HIV. The myriad challenges associated with the diagnosis and management of HIV-leprosy coinfection are also discussed. Thus, although uncommon, atypical cutaneous lesions in HIV-seropositive patients warrant investigation for leprosy.

Leprosy and Human Immunodeficiency Virus Coinfection: A Rare Case Report

Indonesian Journal of Tropical and Infectious Disease

Leprosy, or Hansen disease, is a chronic infectious disease caused by Mycobacterium leprae which is associated with inflammation that may damage the skin and the peripheral nerves. Leprosy remains an important public health problem in Southeast Asia, America, and Africa. It has been speculated that, as with TB, HIV infection may exacerbate leprosy lesions and/or lead to increased susceptibility to leprosy. We report the case of leprosy and HIV co-infection and reveals its clinical manifestation. A 34-year-old female came to outpatient clinic complaining of rednessplaque on her face of 2-months duration. It was also accompanied with thick sensation but without itchy or burning sensation. We found thick erythematous plaque with sharp margin and hypoesthesia on her face and body. There were no madarosis, saddle nose, lagophthalmos, nor sign of neuritis. The slit-skin smear revealed BI 1+ globi and MI 2%. From laboratory examination we found CBC was within normal limit, IgM anti PGL-1 t...