Keywords
Type I Reaction
Pseudo-exacerbation
Classification
How to Cite
Abstract
Type I reactions are one of the greatest problems in the classification of leprosy, and the evolution of its concept is analysed since pre-sulphone era. These reactions occur in established tuberculoid and borderline cases and can suddenly occur, being the only manifestation of the disease. On the other hand they can occur before, during and after treatment. In the opinion of the author, all of them are the expression of the same phenomenon, that is, a delayed type of hypersensitivy to antigens released by destruction of multiplying M.leprae. Based in discussion of these facts it is proposed a new classification of the disease, in which each clinical form is imutable and there is no shift in the immunity.
References
JOPLING, W.H. Classification of lepra reaction (reaction in leprosy) (Letter). Leprosy Rev., v.41, n.1, p.62-63, January, 1970.
WADE, H. Tuberculoid changes in leprosy. II. Int. J. Leprosy, v.2, n.3, p.279-292, August - October.1934.
COCHRANE, R.G. Development of lesions of leprosy with particular reference to tuberculoid leprosy and significance of the lepromin test. Int. J. Leprosy, v.8, p.445-56, 1940.
SOUZA LIMA, L., SOUZA CAMPOS, N. Lepra tuberculóide. São Paulo: Renascença, 1947. p. 173-215.
WADE, H.W., RODRIGUEZ, J.N. Development of major tuberculoid leprosy. Int. J. Leprosy, v.7, n.3, p.327-340, 1939.
FERNANDEZ, J.M.M. Reação leprótica tuberculóide. Rev. bras. leproL, v.4,p. 469-75, 1936.
TAJIRI, Isamu. The "acute infiltration"reaction of lepromatous leprosy. Int. J. Leprosy, v.23, n.3, p.316-317, July-September, 1955.
WADE, H.W., RODRIGUEZ, J.N. Borderline tuberculoid leprosy. Int. J. Leprosy, v.8, n.3, p.307-332,1940.
RODRIGUES, J.N., WADE, W. Bullous tuberculoid leprosy: report of a case, with a discussion of lazarine leprosy. Int. J. Leprosy, v. 8, n.3, p.333-343, 1940.
RYRIE, G.A.. Acute ulcerative or sloughing tuberculoid leprosy. Int. J. Leprosy, v.6, n.2, p.153-160, April-June, 1938.
BASOMBRIO, G. et al. Draft report of classification Committee. In: CONGRESSO INTERNACIONAL DE LEPROLOGIA, 6º, Madrid, 1953. Mamona. p.75, 86.
LATAPI, F. etal. Reação leprótica: In: CONGRESSO INTERNACIONAL DE LEPROLOGIA, Grupo de Trabalho, 8º, Rio de Janeiro, 12 a 20 de setembro de 1963. Relatórios finais das comissões técnicas emsessão plenária de20 de setembro de 1963. p.14-19.
COCHRANE, R.G., SMYLY, H.J. Classificacion. In: COCHRANE, R.G. Leprosy in theory and practive. London: John Wright & Sons, 1964. p.299-309.
LEIKER, D.L. Low-resistant tuberculoid leprosy. Int. J. Leprosy, v. 32, n.4, p.359-367, October-December, 1964.
RIDLEY, D.S., JOPLING, W.H. Classification of leprosy according to immunity: a five-group system. Int. J. Leprosy, v.34, n.3, p.255-271, 1966
RIDLEY, D.S. Reactions in leprosy. Leprosy Rev., v.40, n.2, p.77-81, April, 1969.
LIMA, L.S., SOUZA, P.R. Pseudoexacerbation of leprosy due to the diamino-diphenyl-sulfones. Int. J. Leprosy, v.17, n.1-2, p.19-21. January-June, 1949.
SOUZA LIMA, L. de. Estado atual da terapêutica da lepra. São Paulo: Ministério da Educação e Saúde, 1953. 288p.
WADE, H.W. A tuberculoid-like reaction in lepromatous leprosy (Editorials): Int. J. Leprosy, v.23, n.4, p.443-446, October-December, 1955.
DAVEY, T.F. The treatment of leprosy with sulphetrone. Leprosy Rev., v.19, n.2, p.55-61, April, 1948.
RODRIGUEZ, J.N. "Pseudoexacerbation" ans "borderline"cases (Correspondence). Int. J. Leprosy, v.18, n.1, p.95, January-March, 1950.
JOPLING, W.H. Handbook of leprosy. 2 ed. London: William Heinemann1978.
RIDLEY, D.S. Skin biopsy in leprosy: histological interpretation andclinicalapplication.. 2ed. Basle: Ciba Geigy, c. 1985. (Documenta Geigy).
BECX-BLEUMINK, M., BERHE, D. Occurrence of reactions, their diagnosis and management in leprosy patients treated with multidrug therapy; Experience in the leprosy control program of the all Africa leprosy and rehabilitation training center (ALERT) in Ethiopia. Int. J. Leprosy, v.60, n.2, p.173-184, June, 1992.
SCOLLARD, D.M. et al . Epidemiologic characteristics of leprosy reactions. Int. J. Leprosy. v.62, n.4. p.559-567. December. 1994.
VIJAYAKUMARAN, P., MANIMOZHI, N, JESUDASAN, K. Incidence of Iate lepra reaction among multibacillary leprosy patients after MDT. Int. J. Leprosy, v.63, n.1, p.18-22, March, 1995.
CHIN-A-LIEN, Roël A.M., FABER, William R., NAAFS, Bernard. Cyclosporin treatment in reversal reaction. In: INTERNATIONAL LEPROSY CONGRESS, 14º, Orlando, August 29 thru September, 1993. Abstracts. p.24A.
CHOPRA, N.K., GANAPATI, R., TRIVEDI, M.P. Study of late reversal reaction in paucibacillary patients. After multi drug treatment - its incidence rate, time of onset, mode of presentation and management. In: INTERNATIONAL LEPROSY CONGRESS, 14º, Orlando, August 29 thru September 4, 1993. Abstracts. p.25A.
LOCKWOOD, Diana et al. Natural history and clinical features of reversal reaction in hyderabad, India. In: INTERNATIONAL LEPROSY CONGRESS, 14º, Orlando, August 29 thru September 4, 1993. Abstracts. p.23A.
MULIYIL, Jayaprakash. Factors affecting risk of type I reaction among multibacillary patients. In: INTERNATIONAL LEPROSY CONGRESS, 142, Orlando, August, 29 thru September 4, 1993. Abstracts. p.24 A.
SHARMA, A.K., KAR, H.K., ZAHEER, S.A. Reversal reaction in multibacillary leprosy patients following MDT with/without immunotherapy with a candidate antileprosy vaccine Mycobacterium W. In: INTERNATIONAL LEPROSY CONGRESS, 142, Orlando, August 29 thru September 29. 1993. Abstracts. p. 24A.
PANNIKAR, Vijayakumar, JEDUDASAN, Kumar. Relapse or late reserva) reaction? int J. Leprosy, 57, n.2, p.526-528, 1989.
OPROMOLLA, D.V.A.; URA, S.; GHIDELLA, C. Os tuberculóides reacionais. Hans. Int., v.19, n.2, p.26-33, Dez. - 1994.
NAAFS, B. Reactions in leprosy. Biol. Micobac., v.3, p. 359-403, 1989.
RIDLEY, D.S. Hypersensitivity and immunity reactions and classification (Editorial). Leprosy Rev., v.47, p.171-174, 1976.
OPROMOLLA, D.V.A. Some comments about a case reported by Wade and Rodrigues in the 30's. Hansen. Int., v.20, n.1, p.38-48, Jan-Jun., 1995.
ROSEMBERG, J. Quimioterapia da tuberculose. Rev. Assoc. Med. Bras., v.19, n.1, p.90-100, maio/junho, 1983.
OPROMOLLA, D.V.A., FLEURY, R.N. Classification of leprosy. In: LATAPI, F. et al. Leprosy. Amsterdam: Excerpta Medica, 1980. In: INTERNATIONAL LEPROSY CONGRESS, 11º, Mexico Ci ty, November, 13-18, 1978. Proceedings, 1980.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Downloads
