Hematologic profile of leprosy patients in reactional episode of erythema nodosumleprosum
DOI:
https://doi.org/10.47878/hi.1996.v21.35436Keywords:
Erythema nodosum leprosum, Hematologic findingsAbstract
In this work, eighteen patients in reactional episode of erythema nodosum leprosum (ENL) had their hematologic paramaters evaluated. Eight of these patients had intense and moderate ENL, and ten patients had mild ENL. The results showed that patients with intense and moderate ENL had significant alterations in the hematologic findings: iron deficiency, an increased euglobulin lysis time and hyperfibrinogenemia. Nevertheless, no alteration was observed in the other parameters studied (prothrombin time, Heinz body and fibrinogen degradation products), in all the cases of ENL.
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References
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2. ALBORNOZ, R. M. Aspectos clinicos de la reaccion leprosa. Derm. Venez., 9:993-7, 1970.
3. ALKJAERSIG, N.; FLETCHER, A. P.; SHERRY, S. The mechanism of clot dissolution by plasmina. J. clin. Invest., 38(7):1086-95, July, 1959.
4. AUDIER, A. G. Changes in the activity of blood plasmina after administration of 3- pyridyl acetic acid in leprosy. Correlation of
activity changes with the Mitsuda reaction. Int. J. Leprosy, 36(1):405-12, Mar., 1968.
5. BAITON, D. F.; FINCH, C. A. The diagnosis of iron deficiency anemia. Amer. J. Med., 37(1): 62-70, July, 1964.
6. BAUER, J. D. Numerical evaluation of formed elements of blood. In: GRADWOHL, R. B. H.. Gradwol'sclinical laboratory methods and diagnosis. 8 ed. St. Louis, Mosby, 1980. p 785-808.
7. BELL,W. N. ; ALTON, H. G. Brain extract as substitute for platelet suspensions in thromboplastin generation test. Nature London ), 174: 880-1, Nov., 1954.
8. BETTEX-GALLAND, M. et al. Induction 01 viscous metamorphosis of platelets by other profhylaxis of thromboembolic accidents in the most serious cases of ENL, when all the fibrinolitic activity is deeply damaged. All the drugs that lead to the shortening of the ENL acute reactions must be taken in the early stages, especially those which diminish the acute inflamatory process, since the main events in ENL are directly related with the generalized acute inflammatory process in these patients. means than thrombin. Nature (London), 174: 880-1, Dec., 1963.
9. BRAIN, M. C.; DACIE, J. V.; HOURIHANE, D. O. Microangiopathic haemolytic anemia: the possible role of vascular lesions in
pathogenesis. Brit. J. Haemat., 8:358-74, Oct., 1962.
10. BUCKELL, M. J. The effect of citrate on euglobulin methods of estimating fibrinolytic activity. J. clin. Path., 11(5):403-5, Sep., 1958.
11. BULL, B. S. et al. Microangiopathic haemolytic a n emi a . Me c h a n i sms o f r e d c e l l fragmentation: "in vitro" studies. Brit. J.
Haemat., 14: 643-52, June, 1968.
12. CARTWRIGHT, G. E. The anemia of chronic disorders. Sem in. Haemat. , 3: 351-75, Oct., 1966.
13. CRUMMY, C. S. et al. Microangiopathic hemolytic anemia in Wegener's granulomatosis. Amer. J. Med. , 51(4):544-8, 1971.
14. DRUTZ, D. J.; GUTMAN, R. A. Renal manifestations of leprosy: glomerulonephritis, acomplication of erythema nodosum leprosum. Amer. J. Trop. Med. Hyg., 22: 496-502, July, 1973.
15. ERICKSON, L. A.; HEKMAN, C. M.; LOSKUTOFF, D. J . The pr imar y plasminogen activator inhibitors in endothelial cells, platelets, serum, and plasma are immunologically related. Proc.nat. Acad.Sci. (Wash.),82(24): 87104, Dec., 1985.
16. FLEURY, R. N.; OPROMOLLA, D. V. A. Septicemia com multiplas lesões ósseas supurativas como complicação do eritema nodoso hansênico.Hansen. Int..15(1-2):76-86, 1990.
17. FLEURY, R. N.; BASTAZINI, I.; TONELLO, C. S. Embolia pulmonar no decurso de reação hansênica. Hansen. Int.,2(2):178-83. 1977.
18. FLEURY, R. N.; OPROMOLLA, D. V. A.; TONELLO, C. S. Meningoencefalite por Cryptococcus Neoformans como complic ação de ins uf i c iênc ia vas c ular arteriosclerótica em hanseníase marchowiana. Hansen. Int., 6(2):146-53, 1981.
19. FREIREICH, E. J. et al. Radioactive iron metabolism and erythrocyte survival studies of the mechanisms of the anemia associated
with rheumatoid arthritis. J. din. Invest., 36(7):1043-58, May, 1951.
20. GITLIN, D. ; CRAIG, J. M.; JANEWAY, J. A. Studies on the nature of fibrinoid in the collagen diseases. Amer. J. Path. , 33(1):55-77, Jan./Feb., 1957.
21. HANSEN, H. E. The anemia of chronic disorders: a bag of unsolved questions. Scand. J. Haemat., 31(5): 397-402, Nov., 1983.
22. HARBOE, M. The immunology of leprosy. In: HASTINGS, R. C. Leprosy, New York, Churchill Livingstone, 1985. p. 77-8.
23. HARTER, P. L'erythema nodosum leprosum de Murata. Revue de la litterature -etude de 185 cas. Bull. Soc. Path. exot., 58(2):335-
400, mai/juin, 1965.
24. HAURANI, F. I. et al. Defective reutilization oí iron in the anemia of inflammation. J. clin. Invest., 65:560-70, Apr., 1965.
25. HILLMAN, R. S.; HENDERSON, D. A. The control of marrow production by level of iron supply. J. clin. Invest.. 40: 454-60. Mar..1969.
26. IZAKI, M. ; KION, S. Fibrinolytic phenomenon in erythema nodosum leprosum with special reference to its pathogenesis and treatment. Int. J. Leprosy, 36(4):639-40, Apr., 1968.
27. JAIN, V. K.; VERMA, K. C.; AGGARWAL, S.S. A study of serum fibrinolytic activity in erythema nodosum leprosum (ENL). Leprosy in India, 55(1): 95-9, Jan., 1983.
28. JEFFREY, M. R. Some observations on anemia in rheumatoid arthritis. Blood, 8:502-18, June, 1953.
29. JORDAN, M. et al. Multiple unusual manifestations of Wegener,s granulomatosis. Arthr. and Rheum., 29(12):1527-31, 1986.
30. KWAAN, H. C. Miscellaneous secondary thrombotic microangiopathy. Semin. Hemat., 24(3): 141-7, July, 1987.
31. MEYERS, W. M. Impairment of plasma fibrinolytic activity in leprosy patients. Int. J. Leprosy, 37(4):343-50, Oct./Dec., 1969.
32. MUKHERJEE, A.; GHOSH, S. Study of lepra reaction. Int. J. Leprosy, 42(2):143-9, pr./ June, 1974.
33. QUICK, A. J. Nature of bleeding in jaundice. J. Amer. med. Ass., 110:1958-62, May, 1938.
34. REA, T. H.;LEVAN, N. E. Erythema nodosum leprosum in a general hospital. Arch. Derm., 3(12):1575-80, Dec., 1975.
35. RIDLEY, M. ; RIDLEY, D. S. The immunopathology of erythema nodosum leprosum: the role of extravascular complexes. Leprosy Rev., 54(2):95-107, June, 1983.
36. SARNO, E. N. et al. Serum levels of tumor necrosis factor-alpha and interleukin-1 beta during leprosy reactional sates. Clin. exp.
Immunol., 84:103-8, 1991.
37. SALYER, W. R. ; SALYER, D. C.; HEPTINSTALL, R. H. Scleroderma and microangiopathic hemolytic anemia. Ann. intern. Med., 78:895-7, June, 1973.
38. SCHLEEF, R.R. et al. Cytokine activation of vascular endothelium. Effects on tissuetype plasminogen activator and type 1
plasminogen activator inhibitor. J. biol. Chem., 263(12):5797-803, Apr., 1988.
39. SEN, R. et al. Patterns of erythropoiesis and anaemia in leprosy. Leprosy Rev., 62(2):158-70, June, 1991.
40. SHARDA, D. P. et al. A study of serum fibrinolytic activity in leprosy. Leprosy in India, 52(2):203-8, Apr. , 1979.
41. SMITH, R. S. ALEXANDER, S. Heinz-body anaemia due to dapsone. Brit. med. J., 5122:625-7, Mar., 1959.
42. VAN MOURIK, J. A.; LAWRENCE, D. A.; LOSKUTOFF, D. J. Purification of an inhibitor of plasminogen activator (antiactivator)
synthesized by endothelial cells. J. biol. Chem., 259(23):14914-21, Dec., 1984.
43. VASSALLI, P.; MCCLUSKEY, R. T. The coagulation process and glomerulardisease. Amer. J. Med., 39:179-83, Aug., 1965.
44. WARD, H. P. et al. Serum level of erythropoietin in anemias associated with chronic infection, alignancy and primary hematopoietic disease. J. din. Invest., 50:332-5, Feb., 1971.
45. WATERS, M. F., RIDLEY, D. S. Necrotizing reactions in lepromatous leprosy: a clinical and histological study. Int. J. Leprosy, 31(3):418-36, Oct./Dec., 1963.
46. WEMAMBU, S. N. et al. Erythema nodosum leprosum: a clinical manifestation of the arthus phenomenon. Lancet, 2:933-5, Nov.,
1969.
47. WIRAWAN, R. et al. Investigation of coagulation abnormalities in patients with erythema nodosum leprosum.South Asian J. Trop. med. Publ. Hlth, 10(3):393-7, Sept., 1979.
48. YAMADA, Y. et al. Cytokines, acute phase proteins and tissue injury C-reactive protein opsonizes dead cells for debridement and
stimulates cytokine production. Ann. N. Y. Acad. Sci., 587:351-61, 1990.
2. ALBORNOZ, R. M. Aspectos clinicos de la reaccion leprosa. Derm. Venez., 9:993-7, 1970.
3. ALKJAERSIG, N.; FLETCHER, A. P.; SHERRY, S. The mechanism of clot dissolution by plasmina. J. clin. Invest., 38(7):1086-95, July, 1959.
4. AUDIER, A. G. Changes in the activity of blood plasmina after administration of 3- pyridyl acetic acid in leprosy. Correlation of
activity changes with the Mitsuda reaction. Int. J. Leprosy, 36(1):405-12, Mar., 1968.
5. BAITON, D. F.; FINCH, C. A. The diagnosis of iron deficiency anemia. Amer. J. Med., 37(1): 62-70, July, 1964.
6. BAUER, J. D. Numerical evaluation of formed elements of blood. In: GRADWOHL, R. B. H.. Gradwol'sclinical laboratory methods and diagnosis. 8 ed. St. Louis, Mosby, 1980. p 785-808.
7. BELL,W. N. ; ALTON, H. G. Brain extract as substitute for platelet suspensions in thromboplastin generation test. Nature London ), 174: 880-1, Nov., 1954.
8. BETTEX-GALLAND, M. et al. Induction 01 viscous metamorphosis of platelets by other profhylaxis of thromboembolic accidents in the most serious cases of ENL, when all the fibrinolitic activity is deeply damaged. All the drugs that lead to the shortening of the ENL acute reactions must be taken in the early stages, especially those which diminish the acute inflamatory process, since the main events in ENL are directly related with the generalized acute inflammatory process in these patients. means than thrombin. Nature (London), 174: 880-1, Dec., 1963.
9. BRAIN, M. C.; DACIE, J. V.; HOURIHANE, D. O. Microangiopathic haemolytic anemia: the possible role of vascular lesions in
pathogenesis. Brit. J. Haemat., 8:358-74, Oct., 1962.
10. BUCKELL, M. J. The effect of citrate on euglobulin methods of estimating fibrinolytic activity. J. clin. Path., 11(5):403-5, Sep., 1958.
11. BULL, B. S. et al. Microangiopathic haemolytic a n emi a . Me c h a n i sms o f r e d c e l l fragmentation: "in vitro" studies. Brit. J.
Haemat., 14: 643-52, June, 1968.
12. CARTWRIGHT, G. E. The anemia of chronic disorders. Sem in. Haemat. , 3: 351-75, Oct., 1966.
13. CRUMMY, C. S. et al. Microangiopathic hemolytic anemia in Wegener's granulomatosis. Amer. J. Med. , 51(4):544-8, 1971.
14. DRUTZ, D. J.; GUTMAN, R. A. Renal manifestations of leprosy: glomerulonephritis, acomplication of erythema nodosum leprosum. Amer. J. Trop. Med. Hyg., 22: 496-502, July, 1973.
15. ERICKSON, L. A.; HEKMAN, C. M.; LOSKUTOFF, D. J . The pr imar y plasminogen activator inhibitors in endothelial cells, platelets, serum, and plasma are immunologically related. Proc.nat. Acad.Sci. (Wash.),82(24): 87104, Dec., 1985.
16. FLEURY, R. N.; OPROMOLLA, D. V. A. Septicemia com multiplas lesões ósseas supurativas como complicação do eritema nodoso hansênico.Hansen. Int..15(1-2):76-86, 1990.
17. FLEURY, R. N.; BASTAZINI, I.; TONELLO, C. S. Embolia pulmonar no decurso de reação hansênica. Hansen. Int.,2(2):178-83. 1977.
18. FLEURY, R. N.; OPROMOLLA, D. V. A.; TONELLO, C. S. Meningoencefalite por Cryptococcus Neoformans como complic ação de ins uf i c iênc ia vas c ular arteriosclerótica em hanseníase marchowiana. Hansen. Int., 6(2):146-53, 1981.
19. FREIREICH, E. J. et al. Radioactive iron metabolism and erythrocyte survival studies of the mechanisms of the anemia associated
with rheumatoid arthritis. J. din. Invest., 36(7):1043-58, May, 1951.
20. GITLIN, D. ; CRAIG, J. M.; JANEWAY, J. A. Studies on the nature of fibrinoid in the collagen diseases. Amer. J. Path. , 33(1):55-77, Jan./Feb., 1957.
21. HANSEN, H. E. The anemia of chronic disorders: a bag of unsolved questions. Scand. J. Haemat., 31(5): 397-402, Nov., 1983.
22. HARBOE, M. The immunology of leprosy. In: HASTINGS, R. C. Leprosy, New York, Churchill Livingstone, 1985. p. 77-8.
23. HARTER, P. L'erythema nodosum leprosum de Murata. Revue de la litterature -etude de 185 cas. Bull. Soc. Path. exot., 58(2):335-
400, mai/juin, 1965.
24. HAURANI, F. I. et al. Defective reutilization oí iron in the anemia of inflammation. J. clin. Invest., 65:560-70, Apr., 1965.
25. HILLMAN, R. S.; HENDERSON, D. A. The control of marrow production by level of iron supply. J. clin. Invest.. 40: 454-60. Mar..1969.
26. IZAKI, M. ; KION, S. Fibrinolytic phenomenon in erythema nodosum leprosum with special reference to its pathogenesis and treatment. Int. J. Leprosy, 36(4):639-40, Apr., 1968.
27. JAIN, V. K.; VERMA, K. C.; AGGARWAL, S.S. A study of serum fibrinolytic activity in erythema nodosum leprosum (ENL). Leprosy in India, 55(1): 95-9, Jan., 1983.
28. JEFFREY, M. R. Some observations on anemia in rheumatoid arthritis. Blood, 8:502-18, June, 1953.
29. JORDAN, M. et al. Multiple unusual manifestations of Wegener,s granulomatosis. Arthr. and Rheum., 29(12):1527-31, 1986.
30. KWAAN, H. C. Miscellaneous secondary thrombotic microangiopathy. Semin. Hemat., 24(3): 141-7, July, 1987.
31. MEYERS, W. M. Impairment of plasma fibrinolytic activity in leprosy patients. Int. J. Leprosy, 37(4):343-50, Oct./Dec., 1969.
32. MUKHERJEE, A.; GHOSH, S. Study of lepra reaction. Int. J. Leprosy, 42(2):143-9, pr./ June, 1974.
33. QUICK, A. J. Nature of bleeding in jaundice. J. Amer. med. Ass., 110:1958-62, May, 1938.
34. REA, T. H.;LEVAN, N. E. Erythema nodosum leprosum in a general hospital. Arch. Derm., 3(12):1575-80, Dec., 1975.
35. RIDLEY, M. ; RIDLEY, D. S. The immunopathology of erythema nodosum leprosum: the role of extravascular complexes. Leprosy Rev., 54(2):95-107, June, 1983.
36. SARNO, E. N. et al. Serum levels of tumor necrosis factor-alpha and interleukin-1 beta during leprosy reactional sates. Clin. exp.
Immunol., 84:103-8, 1991.
37. SALYER, W. R. ; SALYER, D. C.; HEPTINSTALL, R. H. Scleroderma and microangiopathic hemolytic anemia. Ann. intern. Med., 78:895-7, June, 1973.
38. SCHLEEF, R.R. et al. Cytokine activation of vascular endothelium. Effects on tissuetype plasminogen activator and type 1
plasminogen activator inhibitor. J. biol. Chem., 263(12):5797-803, Apr., 1988.
39. SEN, R. et al. Patterns of erythropoiesis and anaemia in leprosy. Leprosy Rev., 62(2):158-70, June, 1991.
40. SHARDA, D. P. et al. A study of serum fibrinolytic activity in leprosy. Leprosy in India, 52(2):203-8, Apr. , 1979.
41. SMITH, R. S. ALEXANDER, S. Heinz-body anaemia due to dapsone. Brit. med. J., 5122:625-7, Mar., 1959.
42. VAN MOURIK, J. A.; LAWRENCE, D. A.; LOSKUTOFF, D. J. Purification of an inhibitor of plasminogen activator (antiactivator)
synthesized by endothelial cells. J. biol. Chem., 259(23):14914-21, Dec., 1984.
43. VASSALLI, P.; MCCLUSKEY, R. T. The coagulation process and glomerulardisease. Amer. J. Med., 39:179-83, Aug., 1965.
44. WARD, H. P. et al. Serum level of erythropoietin in anemias associated with chronic infection, alignancy and primary hematopoietic disease. J. din. Invest., 50:332-5, Feb., 1971.
45. WATERS, M. F., RIDLEY, D. S. Necrotizing reactions in lepromatous leprosy: a clinical and histological study. Int. J. Leprosy, 31(3):418-36, Oct./Dec., 1963.
46. WEMAMBU, S. N. et al. Erythema nodosum leprosum: a clinical manifestation of the arthus phenomenon. Lancet, 2:933-5, Nov.,
1969.
47. WIRAWAN, R. et al. Investigation of coagulation abnormalities in patients with erythema nodosum leprosum.South Asian J. Trop. med. Publ. Hlth, 10(3):393-7, Sept., 1979.
48. YAMADA, Y. et al. Cytokines, acute phase proteins and tissue injury C-reactive protein opsonizes dead cells for debridement and
stimulates cytokine production. Ann. N. Y. Acad. Sci., 587:351-61, 1990.
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1999-06-30
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Freitas TC de, Fleury RN. Hematologic profile of leprosy patients in reactional episode of erythema nodosumleprosum. Hansen. Int. [Internet]. 1999 Jun. 30 [cited 2024 May 19];21(1):52-7. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/35436
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