Tuberculoid leprosy in aids patient
DOI:
https://doi.org/10.47878/hi.2004.v29.36385Keywords:
leprosy, type 1 reaction, aids, restoring of the immune responseAbstract
The authors present an 8 year-old child with AIDS, infected by vertical transmission, who developed the first tuberculoid leprosy manifestations prior to the beginning of the anti-retroviral treatment. The initially noticed lesions were ulcers with hard edges which healed and ulcerated consecutively. The CD4+ count was 0,3 cells. This count remained until the first confirmatory leprosy exams were performed. In that occasion, during the anti-retroviral treatment, the CD4+ count was 270. A cutaneous biopsy was taken. When the patient returned for the histopathology result, the ulcers had healed and a sarcoidic aspect of the lesion was noted. The Mitsuda reaction was 8,5 mm, there was hypostesia of the left leg
and the leprosy diagnosis was reached mainly supported by the anti-5100 protein immunohistochemistry staining that showed fragments of nerve branches inside granulomas. The incidence of leprosy has not increased because of AIDS. There haven't been changes in the clinical presentation and in the response to therapy in cases of leprosy associated with AIDS. We haven't also observed development of type 1 reaction in this patient
resulting from restoring of the immune response after the anti-retroviral treatment.
Downloads
References
2 Belliappa AD, Bhat RM, Martins I. Leprosy in type I reaction and diabetes mellitus in a patient with HIV Infection. Int j dermatol 2002; 41:694-695.
3 Blum L, Flageul B, Sow S, Launois P, Vignon-Pennamen M, Coll A, Milian J. Leprosy reversal reaction in HIV positive patients. Int j lepr 1993; 61:214-217
4 Couppté P, Abel 5, Voinchet H, Roussel M, Hélénon R, Huerre M et al. Immune reconstitution inflammatory syndrome associated with HIV and leprosy. Arch dermatol 2004; 140:997-1000.
5 F a y e O , M a h e A , l ame t P , H u e r r e M , B o b i n P . E t u d e anatomopathologique de 5 cas de lepre chez dês sujets séropositifs pour lê vírus de I´immunodéficience humaine (VIM. Acta leprol 1996; 10(2):93-96.
6 Lawn SD, Wood C, Lockwood DN. Borderline Tuberculoid leprosy: an immune reconstitution phenomenon in a human immunodeficiency-virus
infected person. Clin infect dis 2003; Jan 36(1):5-6.
7 Lucas S. Human immunodefiency virus and leprosy. Lepr rev. 1993, 64:97-103.
8 Moreno-Gimenez IC, Valverdet F, Logronos C, Rubio F L, Lepromatous Leprosy in an HIV-positive patient in Spain. European acari dermatol venereal 2000, 14:290-292.
9 Naafs B. Hanseníase e HIV: uma análise. Hansen int 2000; 25111:63-66.
10 Opromolla DVA, Tonello CIS, Fleury RN. Hanseníase dimorfa e infecção pelo HIV (aids). Hansen int 2000; 25(1):54-59.
11 Opromolla DVA, Ura 5, Fleury RN, Daher FC, Pagung R. Reação hansênica tipo I úlcerada. Hansen ín11998, 23(1,2):5-13.
12 Pereira Jr AC, Caneschi JR, Azu lay MM, Trope BM, Ave B, Carneiro SCS, Azulay RD. O estudo da resposta imune em pacientes com infecção pelo vírus da imunorleficiência humana (HIV) em relação ao antígeno de Mitsurla. An bras dermatol 1992; 67(3):97-102.
1 3 L ima L S , C amp o s NS . L e p r i d e s t u b e r c u l o í d e s r e a c i o n a i s . I n : . L e p r a T u b e r c u l ó d e . S ã o P au l o : R e n a s c e n ç a ; 1 9 4 7 . p.173-215.
14 Vreeburg AEM. Cl inical observat ions on leprosy pat ient wih HIV 1- infection in Zâmbia. Lepr rev 1992; 63:134-140.
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
This journal is licensed under a Creative Commons Attribution 4.0 International License.
