Insuficiência hepática na hanseníase devida a amiloidose

Abstract

A case of hanseniasis with uncommonly severe secondary amyloidosis is reported and discussed. Clinical, laboratory and postmortem findings show large involvement of the liver and hepatic deficiency, the principal cause of death. Hepatic deficiency with portal hypertension has been described in primary
amyloidosis, but in the secondary type, as in this case, it has only been reported once, by Manzi et al (1071). It is attributed to pro tracted long term hanseniasis, hansenw reactions of the erythema nodosum type and osteomyelitis related to plantar ulcerations, all those conditions leading to an excess of antigenic
stimulation and debilitation of the humoral response. Although 25% of deaths due to hansensasis in the West are caused by amyloidosis of the kidneys causing a nephrotie syndrome, in this case it did not lead to serious renal dysfunction.