Prognostic considerations based on a study of 38 hanseniasis patients submitted to Mitsuda tests 23 to 35 years previously

MAURICIO M. A. ALCHORNE; ABRAHÃO ROTBERG; JORGE MICHALANY; PAULO DE O. VARGAS; TUPY P. CASSIANO

doi:10.47878/hi.1978.v3.35636

Autores

MAURICIO M. A. ALCHORNE Professor of Dermatology, Faculdade de Medicina, Universidade de Mogi das Cruzes, S. Paulo, Brazil. Assistant-Professor of Dermatology, Escola Paulista de Medicina, S. Paulo, Brazil.
ABRAHÃO ROTBERG Professor of Dermatology, Universidade de S. Paulo, Brazil. Chairman of the Hansenology Committee, S. Paulo State Public Health Service, Brazil.
JORGE MICHALANY Professor of Pathology, Escola Paulista de Medicina, S. Paulo, Brazil.
PAULO DE O. VARGAS Head of the Health Unit Lapa, of the S. Paulo State Public Health Service, Brazil.
TUPY P. CASSIANO Head of the Health Unit Bom Retiro, of the S. Paulo State Public Health Service, Brazil.

DOI:

https://doi.org/10.47878/hi.1978.v3.35636

Palavras-chave:

Hanseniasis, Mitsuda test, Prognosis, Immunology in hanseniasis

Resumo

Out of 2.775 hanseniasis patients Mitsuda tested by one of the authors (R) from 1933 to 1947, 38 were re-examined in 1970/1971. 28 had been treated regularly, 6 did not receive sulfones. Improvement or disappearance of dermatological lesions occurred in 31 (81.5%), independently of reactivity. All eleven bacteriologically positive out of 19 Mitsuda negative patients became bacteriologically negative, which is partly attributed to sulfones. One treated bacillary negative patient became positive. 28 (76,3%) were neurollogically aggravated, independently of reactivity but more evidently among the stronger reactors. As regards classification, all initially "tuberculoid", "Virchowian" and "dimorphous" patients continued in their types or group, but only 7 (41.2%) out of the 17 initially "indetermined" remained so. Four (23.5%) two Mitsuda+ +, two+ changed to reactional tuberculoid, 6 (35,3%) (3 Mitsuda — 2+ and 1+ +) changed to the Virchowian type. These developments according to reactivity confirm the pathogenetic theory postulated in 1937 by one of the authors (R). Mitsuda reactivity remained generally unchanged, rarely increased or decreased. The good prognostic value of the strong Mitsuda test is generally confirmed, but only as regards classification, bacillation and dermatological lesions — not from the neurological and social viewpoints.

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