Risk factors for type-1 reactions in borderline leprosy patients

Type-1 or reversal reactions are the major cause of nerve damage and disability in leprosy. We wished to determine whether there were any clinical or laboratory markers that identified patients with an increased risk of type-1 reaction. 42 (31%) of 136 Nepalese borderline leprosy patients (97 male,...

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Bibliographic Details
Published in:The Lancet (British edition) 1991-09, Vol.338 (8768), p.654-657
Main Authors: Roche, P.W., Theuvenet, W.J., Britton, W.J.
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Antibodies
Antibodies, Bacterial - analysis
Antibodies, Monoclonal - analysis
Antigens
Antigens, Bacterial
Bacteria
Bacterial diseases
Biological and medical sciences
Biomarkers - blood
Chemotherapy
Child
Drug Hypersensitivity - etiology
Drug Hypersensitivity - immunology
Drug therapy
Drugs
Female
Glycolipids - immunology
Human bacterial diseases
Humans
Immune response
Immunity, Cellular
Immunoglobulin G
Immunoglobulin M
Immunoglobulins
Infectious diseases
Inflammation
Intradermal Tests
Lepromin test
Leprosy
Leprosy, Borderline - drug therapy
Leprosy, Borderline - immunology
Leprosy, Tuberculoid - drug therapy
Lipopolysaccharides - immunology
Male
Medical research
Medical sciences
Middle Aged
Mycobacterium leprae - immunology
Neuritis - chemically induced
Neuritis - immunology
Patients
Peripheral Nervous System Diseases - chemically induced
Peripheral Nervous System Diseases - immunology
Phenolic compounds
Phenols
Proteins
Risk analysis
Risk Factors
Skin
Smear
Tropical bacterial diseases
Tropical medicine
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Summary:Type-1 or reversal reactions are the major cause of nerve damage and disability in leprosy. We wished to determine whether there were any clinical or laboratory markers that identified patients with an increased risk of type-1 reaction. 42 (31%) of 136 Nepalese borderline leprosy patients (97 male, 39 female; age range 7-73 years) had a type-1 reaction during the first 2 years of multi-drug therapy. Before therapy, 41 (98%) of the 42 patients were seropositive for antibodies to one of three mycobacterial antigens. Seropositivity for IgM anti-phenolic-glycolipid-1 (PGL-1) antibodies, but not IgG anti-lipoarabinomannan or anti-Mycobacterium leprae 35 kDa protein antibodies, was significantly associated with subsequent manifestation of a type-1 reaction (p
ISSN:0140-6736
1474-547X
DOI:10.1016/0140-6736(91)91232-J