Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings

Detalhes bibliográficos
Autor(a) principal: Barreto, Jaison Antônio
Data de Publicação: 2007
Outros Autores: Marinho, Fernanda Chagas de Alencar, Contin, Letícia Arsie, Nogueira, Maria Esther S.
Tipo de documento: Artigo
Idioma: por
Título da fonte: Hansenologia Internationalis (Online)
Texto Completo: https://periodicos.saude.sp.gov.br/hansenologia/article/view/36305
Resumo: A 51 years old man has the diagnosis of borderline leprosy in 2005. On this time he presented 3 honeycombed plaques and some little papules on the back. The histopathology showed active borderline-lepromatous leprosy, bacilloscopy 5+, with viable bacilli. Mitsuda reaction was negative, the dosage of IgM anti-PGL-1 (phenolic glicolipid 1) by ELISA was 0,003 and ML-Flow test (lateral flux test to M. leprae) was negative. Multidrugtherapy (MDT) for multibacillary leprosy was started for 24 months. Nine months after finished treatment, reversal reaction characterized by exacerbation of previous lesions and appearance of multiple erythematous nodules on face, trunk and extremities. The histopathology showed reactional borderline-tuberculoid pattern, with bacilloscopy 1+, granular bacilli. It is discussed the differential diagnosis between relapse and reversal reaction, the reactivation of the disease with multiple nodules mimicking lepromas and the low values of IgM anti-PGL-1 and the negative ML-flow test on the diagnosis.
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spelling Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findingsReação reversa nodular tardia simulando recidiva: a importância da história clínica e dos exames laboratoriaisHanseníase dimorfaHipersensibilidade tipo IVPoliquimioterapiaBorderline leprosyType IV HipersensitivitPolychemotherapyA 51 years old man has the diagnosis of borderline leprosy in 2005. On this time he presented 3 honeycombed plaques and some little papules on the back. The histopathology showed active borderline-lepromatous leprosy, bacilloscopy 5+, with viable bacilli. Mitsuda reaction was negative, the dosage of IgM anti-PGL-1 (phenolic glicolipid 1) by ELISA was 0,003 and ML-Flow test (lateral flux test to M. leprae) was negative. Multidrugtherapy (MDT) for multibacillary leprosy was started for 24 months. Nine months after finished treatment, reversal reaction characterized by exacerbation of previous lesions and appearance of multiple erythematous nodules on face, trunk and extremities. The histopathology showed reactional borderline-tuberculoid pattern, with bacilloscopy 1+, granular bacilli. It is discussed the differential diagnosis between relapse and reversal reaction, the reactivation of the disease with multiple nodules mimicking lepromas and the low values of IgM anti-PGL-1 and the negative ML-flow test on the diagnosis.Um homem de 51 anos recebe o diagnóstico de hanseníase dimorfa em 2005. Na ocasião apresentou 3 lesões em placas foveolares e algumas pequenas pápulas no tronco posterior. A histopatologia mostrou quadro ativo de Hanseníase dimorfa-virchoviana com baciloscopia de 5+ (presença de bacilos típicos). A reação de Mitsuda foi negativa, a dosagem de IgM anti-PGL-1 (glicolipídeo fenólico 1) por ELISA foi de 0,003 e o teste ML-Flow (teste de fluxo lateral para o M. leprae) foi negativo. Submeteu-se a poliquimioterapia (PQT) para multibacilar (24 doses). Nove meses após a alta medicamentosa, inicia episódio reacional caracterizado por tumefação e eritema das placas pré-existentes, e múltiplos nódulos eritematosos generalizados em face, tronco e extremidades. A histopatologia demonstrou padrão granulomatoso dimorfo-tuberculóide reacional com 1+ de bacilos granulosos. Discute-se o diagnóstico diferencial entre recidiva e reação reversa, a reativação com múltiplos nódulos semelhantes a hansenomas e os valores de IgM anti PGL-1 e o teste de ML-Flow negativo por ocasião do diagnóstico da doença.Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo2007-11-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAvaliado pelos paresapplication/pdfhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/3630510.47878/hi.2007.v32.36305Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 32 No. 2 (2007); 197-202Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 32 n. 2 (2007); 197-2021982-5161reponame:Hansenologia Internationalis (Online)instname:Instituto Lauro de Souza Lima (ILSL)instacron:ILSLporhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/36305/34593https://creativecommons.org/licenses/by/4.0info:eu-repo/semantics/openAccessBarreto, Jaison AntônioMarinho, Fernanda Chagas de AlencarContin, Letícia ArsieNogueira, Maria Esther S.2023-02-17T18:45:11Zoai:ojs.periodicos.saude.sp.gov.br:article/36305Revistahttps://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:2023-02-17T18:45:11Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL)false
dc.title.none.fl_str_mv Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
Reação reversa nodular tardia simulando recidiva: a importância da história clínica e dos exames laboratoriais
title Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
spellingShingle Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
Barreto, Jaison Antônio
Hanseníase dimorfa
Hipersensibilidade tipo IV
Poliquimioterapia
Borderline leprosy
Type IV Hipersensitivit
Polychemotherapy
title_short Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
title_full Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
title_fullStr Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
title_full_unstemmed Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
title_sort Late nodular reversal reaction mimicking relapse: the importance of clinical history and laboratory findings
author Barreto, Jaison Antônio
author_facet Barreto, Jaison Antônio
Marinho, Fernanda Chagas de Alencar
Contin, Letícia Arsie
Nogueira, Maria Esther S.
author_role author
author2 Marinho, Fernanda Chagas de Alencar
Contin, Letícia Arsie
Nogueira, Maria Esther S.
author2_role author
author
author
dc.contributor.author.fl_str_mv Barreto, Jaison Antônio
Marinho, Fernanda Chagas de Alencar
Contin, Letícia Arsie
Nogueira, Maria Esther S.
dc.subject.por.fl_str_mv Hanseníase dimorfa
Hipersensibilidade tipo IV
Poliquimioterapia
Borderline leprosy
Type IV Hipersensitivit
Polychemotherapy
topic Hanseníase dimorfa
Hipersensibilidade tipo IV
Poliquimioterapia
Borderline leprosy
Type IV Hipersensitivit
Polychemotherapy
description A 51 years old man has the diagnosis of borderline leprosy in 2005. On this time he presented 3 honeycombed plaques and some little papules on the back. The histopathology showed active borderline-lepromatous leprosy, bacilloscopy 5+, with viable bacilli. Mitsuda reaction was negative, the dosage of IgM anti-PGL-1 (phenolic glicolipid 1) by ELISA was 0,003 and ML-Flow test (lateral flux test to M. leprae) was negative. Multidrugtherapy (MDT) for multibacillary leprosy was started for 24 months. Nine months after finished treatment, reversal reaction characterized by exacerbation of previous lesions and appearance of multiple erythematous nodules on face, trunk and extremities. The histopathology showed reactional borderline-tuberculoid pattern, with bacilloscopy 1+, granular bacilli. It is discussed the differential diagnosis between relapse and reversal reaction, the reactivation of the disease with multiple nodules mimicking lepromas and the low values of IgM anti-PGL-1 and the negative ML-flow test on the diagnosis.
publishDate 2007
dc.date.none.fl_str_mv 2007-11-30
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/36305
10.47878/hi.2007.v32.36305
url https://periodicos.saude.sp.gov.br/hansenologia/article/view/36305
identifier_str_mv 10.47878/hi.2007.v32.36305
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv https://periodicos.saude.sp.gov.br/hansenologia/article/view/36305/34593
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. 32 No. 2 (2007); 197-202
Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 32 n. 2 (2007); 197-202
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_ 1796797581025607680

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