Number of leprosy reactions during treatment: clinical correlations and laboratory diagnosis

• Published in: Revista da Sociedade Brasileira de Medicina Tropical 2016-11, Vol.49 (6), p.741-745
• Main Authors: Antunes, Douglas Eulálio, Ferreira, Gabriela Porto, Nicchio, Mariana Vitorino Candeiro, Araujo, Sergio, Cunha, Ana Carolina Rodrigues da, Gomes, Rafaela Resende, Costa, Adeilson Viera da, Goulart, Isabela Maria Bernardes
• Format: Article
• Language: English
• Subjects: Antibodies, Bacterial - blood; Antigens, Bacterial - blood; Clinical correlation; Clinical trials; Correlation analysis; Cross-Sectional Studies; Drug therapy; Drug Therapy, Combination; Humans; Laboratories; Laboratory diagnosis; Leprostatic Agents - administration & dosage; Leprostatic Agents - adverse effects; Leprosy; Leprosy - drug therapy; Leprosy - microbiology; Leprosy reactions; Medical diagnosis; Mycobacterium leprae; Mycobacterium leprae - drug effects; Mycobacterium leprae - immunology; Statistics, Nonparametric; Time Factors; TROPICAL MEDICINE
• ISSN: 0037-8682; 1678-9849; 1678-9849; 0037-8682
• DOI: 10.1590/0037-8682-0440-2015

The occurrence of leprosy reactions, a common event during treatment, may be mostly related to the action of multidrug therapy on Mycobacterium leprae. The clinical and laboratory monitoring of patients with reactions is important, since collecting data that assists in predicting the risk of reactions may help to prevent disability. This was a sectional study, in order to correlate clinical and laboratory diagnosis with the number of reactions during treatment. Spearman's correlation was used to verify the degree of association between the assessed variables. This study was conducted with 211 patients with leprosy reactions during treatment of M. leprae. The borderline tuberculoid group was the most prevalent clinical form (74/211; 35.1%) and the type one reaction showed the highest frequency (136/211; 64.5%). It was observed that 73.5% (155/211) of reactions occurred within 3 months of the initiation of multidrug therapy. The diagnostic values, including the bacterial indices (BIs) of dermal smears (r = 0.21, p < 0.05) and skin biopsies (r = 0.20; p < 0.05), showed a positive correlation with the number of reactions during treatment. This research showed a positive correlation between bacillary load markers and the number of leprosy reactions. This study provided scientific support to future research aiming to elucidate the influence of antigenic load on the number of leprosy reactions during treatment.