Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?

Detalhes bibliográficos
Autor(a) principal: Barreto, Jaison Antonio
Data de Publicação: 2006
Outros Autores: Goya, Flávio, Miranda, Rubem Mateus C
Tipo de documento: Artigo
Idioma: por
Título da fonte: Hansenologia Internationalis (Online)
Texto Completo: https://periodicos.saude.sp.gov.br/hansenologia/article/view/36360
Resumo: A 31 years old man looked for specialized health service due to sensibility changes in his left arm. Clinical examination confi rmed this complaint. Skin smears collected from the altered area did not show acid-fast bacilli. Mitsuda reaction was negative and a biopsy from the skin did not show any bacilli or infl ammatory process. The diagnosis was indeterminate (early) leprosy, and multidrugtherapy for paucibacillary leprosy was started. Nine years later, he returns with several lesions characteristics of borderline leprosy, which was confi rmed by skin biopsy and bacilloscopy of skinsmears. The previous treatment may have not destroy all the bacilli. In this situation remnant bacilli could have replicated, slowly and rogressively, reproducing the large period of incubation typical of individuals with negative Mitsuda reaction. Limitations of diagnosis based only in clinical features and in the lesions count criteria are discussed.
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spelling Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?Hanseníase dimorfa reativada: recidiva ou tratamento insuficiente em paciente imunologicamente suscetível?hanseníase dimorfarecidivatratamentoreação de MitsudaA 31 years old man looked for specialized health service due to sensibility changes in his left arm. Clinical examination confi rmed this complaint. Skin smears collected from the altered area did not show acid-fast bacilli. Mitsuda reaction was negative and a biopsy from the skin did not show any bacilli or infl ammatory process. The diagnosis was indeterminate (early) leprosy, and multidrugtherapy for paucibacillary leprosy was started. Nine years later, he returns with several lesions characteristics of borderline leprosy, which was confi rmed by skin biopsy and bacilloscopy of skinsmears. The previous treatment may have not destroy all the bacilli. In this situation remnant bacilli could have replicated, slowly and rogressively, reproducing the large period of incubation typical of individuals with negative Mitsuda reaction. Limitations of diagnosis based only in clinical features and in the lesions count criteria are discussed.Um homem de 31 anos de idade procurou o serviço de saúde especializado devido a alterações de sensibilidade em braço esquerdo. O exame clínico deu suporte a esta queixa. Os esfregaços obtidos a partir da linfa colhida nesta área não desmontraram bacilos álcool-ácido resistentes (BAAR). A reação de Mitsuda foi negativa e uma biópsia do local não mostrou bacilos ou reação infl amatória. Mesmo assim optou-se pelo diagnóstico de hanseníase indeterminada, e foi instituída a poliquimioterapia para paucibacilar. Nove anos após, o paciente retorna apresentando várias lesões de padrão dimorfo, com quadro histopatológico característico e baciloscopia do esfregaço e da biópsia positiva. Os autores consideram que este indivíduo já era um multibacilar por ocasião do primeiro diagnóstico em 1997 e o tratamento insufi ciente não conseguiu destruir todos os bacilos. Nesta situação, os bacilos remanescentes poderiam ter proliferado lenta e progressivamente, reproduzindo o longo período de incubação próprio dos indivíduos Mitsuda negativos. Discutem- se as limitações do diagnóstico exclusivamente clínico e baseado no número de lesões específicas.Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo2006-11-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAvaliado pelos paresapplication/pdfhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/3636010.47878/hi.2006.v31.36360Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 31 No. 2 (2006); 35-38Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 31 n. 2 (2006); 35-381982-5161reponame:Hansenologia Internationalis (Online)instname:Instituto Lauro de Souza Lima (ILSL)instacron:ILSLporhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/36360/34635https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessBarreto, Jaison AntonioGoya, FlávioMiranda, Rubem Mateus C2023-02-17T18:52:19Zoai:ojs.periodicos.saude.sp.gov.br:article/36360Revistahttps://periodicos.saude.sp.gov.br/hansenologiaPRIhttps://periodicos.saude.sp.gov.br/hansenologia/oaihansen_int@ilsl.br || hansenologia.internationalis@gmail.com || periodicossp@saude.sp.gov.br1982-51610100-3283opendoar:2023-02-17T18:52:19Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL)false
dc.title.none.fl_str_mv Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
Hanseníase dimorfa reativada: recidiva ou tratamento insuficiente em paciente imunologicamente suscetível?
title Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
spellingShingle Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
Barreto, Jaison Antonio
hanseníase dimorfa
recidiva
tratamento
reação de Mitsuda
title_short Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
title_full Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
title_fullStr Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
title_full_unstemmed Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
title_sort Reactivated borderline leprosy: relapse or insuffi cient treatment in immunologically susceptible patient?
author Barreto, Jaison Antonio
author_facet Barreto, Jaison Antonio
Goya, Flávio
Miranda, Rubem Mateus C
author_role author
author2 Goya, Flávio
Miranda, Rubem Mateus C
author2_role author
author
dc.contributor.author.fl_str_mv Barreto, Jaison Antonio
Goya, Flávio
Miranda, Rubem Mateus C
dc.subject.por.fl_str_mv hanseníase dimorfa
recidiva
tratamento
reação de Mitsuda
topic hanseníase dimorfa
recidiva
tratamento
reação de Mitsuda
description A 31 years old man looked for specialized health service due to sensibility changes in his left arm. Clinical examination confi rmed this complaint. Skin smears collected from the altered area did not show acid-fast bacilli. Mitsuda reaction was negative and a biopsy from the skin did not show any bacilli or infl ammatory process. The diagnosis was indeterminate (early) leprosy, and multidrugtherapy for paucibacillary leprosy was started. Nine years later, he returns with several lesions characteristics of borderline leprosy, which was confi rmed by skin biopsy and bacilloscopy of skinsmears. The previous treatment may have not destroy all the bacilli. In this situation remnant bacilli could have replicated, slowly and rogressively, reproducing the large period of incubation typical of individuals with negative Mitsuda reaction. Limitations of diagnosis based only in clinical features and in the lesions count criteria are discussed.
publishDate 2006
dc.date.none.fl_str_mv 2006-11-30
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
Avaliado pelos pares
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://periodicos.saude.sp.gov.br/hansenologia/article/view/36360
10.47878/hi.2006.v31.36360
url https://periodicos.saude.sp.gov.br/hansenologia/article/view/36360
identifier_str_mv 10.47878/hi.2006.v31.36360
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://periodicos.saude.sp.gov.br/hansenologia/article/view/36360/34635
dc.rights.driver.fl_str_mv https://creativecommons.org/licenses/by/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv https://creativecommons.org/licenses/by/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo
publisher.none.fl_str_mv Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo
dc.source.none.fl_str_mv Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 31 No. 2 (2006); 35-38
Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 31 n. 2 (2006); 35-38
1982-5161
reponame:Hansenologia Internationalis (Online)
instname:Instituto Lauro de Souza Lima (ILSL)
instacron:ILSL
instname_str Instituto Lauro de Souza Lima (ILSL)
instacron_str ILSL
institution ILSL
reponame_str Hansenologia Internationalis (Online)
collection Hansenologia Internationalis (Online)
repository.name.fl_str_mv Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL)
repository.mail.fl_str_mv hansen_int@ilsl.br || hansenologia.internationalis@gmail.com || periodicossp@saude.sp.gov.br
_version_ 1796797581067550720

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