medigraphic.com
ISSN 1727-897X (Electronic)

2012, Number 6

<< Back Next >>

Medisur 2012; 10 (6)

Hansen's Disease with Torpid Evolution. A Case Report

Cabrera AG, Bernardez RJ, García DM

Language: Spanish
References: 16
Page: 535-539
PDF size: 80.94 Kb.


ABSTRACT

We report the case of a female patient with cutaneous manifestations of leprosy, whose clinical presentation was atypical and of torpid evolution. From disease onset, the patient developed polymorphic skin lesions accompanied by sensory disturbances. The initial diagnosis was indeterminate leprosy. Multibacillary treatment was indicated. After two years of evolution, given the exacerbation of lesions and general symptoms worsening, biopsy was performed again, providing the following histological result: Hansen dimorphic, the result of the sputum smear being negative. In 2001, a nerve conduction study showed axomielynic damage in the sensory fibers of the right crural nerve. In 2004 the patient presented hives without stinging that left white stains when they disappeared. From that date until 2008 she continued to refer the disease. Multidisciplinary interconsultation was performed in coordination with the national team leader and she was assessed at the meeting of specialists in Havana City, where they initiated therapy with rifampicin, ofloxacin and minocycline, under which she remained for a year, with a satisfactory outcome.


REFERENCES

  1. Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th. ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009.

  2. Ernst JD. Leprosy (Hansen's disease). In: Goldman L, Ausiello D, eds. Cecil Medicine. 24th. ed. Philadelphia, Pa: Saunders Elsevier; 2011:334-45.

  3. Neyra J. Reflexiones acerca de la enfermedad de Hansen(Lepra). Rev Per Med Exp Salud Pública[revista en Internet]. 2005[citado 23 Feb 2012];22(1):[aprox. 4 p.]. Disponible en: http://www.scielo.org.pe/scielo.php? script=sci_arttext&pid=S1726-46342005000100014.

  4. Díaz Almeida JG. Lepra. En: Manzur Katrib J, Díaz Almeida JG, Cortés Hernández M. Dermatología. La Habana: Editorial Ciencias Médicas; 2002. p. 200-22.

  5. Morente Parra M. La imagen de la lepra en las Cantigas de Santa María de Alfonso X El Sabio. Anales de Historia del Arte. 2007;17:25-45.

  6. Rada E, Aranzazu N, Convit J. Respuesta inmunitaria de la enfermedad de Hansen. Invest Clin[revista en Internet]. 2009[citado 23 Ene 2011];50(4):[aprox. 18 p.]. Disponible en: http://www.scielo.org.ve/scielo.php? script=sci_arttext&pid=S0535-51332009000400011&lng=es&nrm=iso&tlng=es.

  7. Suárez Moreno O, Hurtado Gascón L, Pesán Hernández O, Lugo Suárez O, Tápanes Fernández T, Hernández Gutiérrez O, et al. Diagnóstico de la lepra. Manual práctico para MGI. Ciudad de La Habana: Instituto de Medicina Tropical Pedro Kouri; 2007.

  8. Neonakis IK, Gitti Z, Kontos F, Baritaki S, Zerva L, Krambovitis E, Spandidos DA. Report of 2 indigenous cases of leprosy from a European country: use of polymerase chain reaction-restriction fragment length polymorphism analysis of hsp65 gene for identification of Mycobacterium leprae directly from a clinical sample. Diagn Microbiol Infect Dis. 2009;64(3):331-3.

  9. Sasaki S, Takeshita F, Okuda K, Ishii N. Mycobacterium leprae and leprosy: a compendium. Microbiol Immunol. 2001;45(11):729-36.

  10. Fulco TO, Lopes UG, Sarno EN, Sampaio EP, Saliba AM. The proteasome function is required for Mycobacterium leprae-induced apoptosis and cytokine secretion. Immunol Lett. 2007;110(1):82-5.

  11. La eliminación de la lepra en las Américas. Boletín Epidemiológico[revista en Internet]. 1996[citado 23 Mar 2010];17(3):[aprox. 6 p.]. Disponible en: http://www.paho.org/spanish/sha/epibul_95-98/bs963lep.htm.

  12. World Health Organization. Leprosy. Global situation[Internet]. Geneva: WHO; 2012[citado 23 Feb 2012]. Disponible en: http://www.who.int/lep/situation/en/.

  13. Organización Panamericana de la Salud. Situación de la lepra en la región de las Américas[Internet]. Washington: OPS; 2006[citado 30 Ene 2010]. Disponible en: http://www.paho.org/Spanish/AD/DPC/CD/lep-americas.pdf.

  14. Sabatés Martínez MM, Curbelo Alonso M, Cabrera Pereda MJ, Bernárdez Cruz J. Formas de diagnóstico y discapacidades por lepra en la provincia de Cienfuegos de 1980 a 2005. Medisur[revista en Internet]. 2012[citado 25 Abr 2012];10(1):[aprox. 5 p.]. Disponible en: http://www.medisur.sld.cu/index.php/medisur/article/ view/2030/7090.

  15. Walsh DS, Lane JE, Abalos RM, Myint KS. TUNEL and limited immunophenotypic analyses of apoptosis in paucibacillary and multibacillary leprosy lesions. FEMS Immunol Med Microbiol. 2004;41(3):265-9.

  16. Duthie MS, Goto W, Ireton GC, Reece ST, Sampaio LH, Grassi AB, et al. Antigen-specific T-cell responses of leprosy patients. Clin Vaccine Immunol. 2008;15(11):1659-65.




2020     |     www.medigraphic.com