Some comments about a case reported by Wade and Rodrigues In the 30's.
Autor(a) principal: | |
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Data de Publicação: | 1995 |
Tipo de documento: | Artigo |
Idioma: | por eng |
Título da fonte: | Hansenologia Internationalis (Online) |
Texto Completo: | https://periodicos.saude.sp.gov.br/hansenologia/article/view/35449 |
Resumo: | WADE and RODRIGUES reported a leprosy case who was followed up during a period of eight years (1932-1940). Initially the patient was thought to be a minor tuberculoid that evolved rapidly and transformed into a major tuberculoid form. After a period of almost two years without manifestation of the disease he presented new and more severe reactional episodes which later become bullous. The case was considered borderline by its evolution, features of the lesions and bacterial findings. The author considered this case as a reactional one since the beginning and commented also its evolution and clinical and bacteriological aspects. He called attention to the regression of the lesions and the disappearance of bacilli without therapeutic influence and later the occurrence of new outbreaks and reappearance of bacilli, even after a large period of time. This report permitted to elaborate an hypothesis in which the bacilli in reactional borderline cases disappear in most part due to the action of the immune system of the host in contrast with reactional tuberculoid cases in which there is a total destruction of bacilli, therefore, the new outbreaks are caused by multiplication of persisters. Confirmation of this hypothesis could have therapeutic implications. MDT/ WHO would be unable to prevent new reactional episodes since the bacterial multiplication occurs out of the period of drug activity. If so, reversal reaction that occur after treatment could actually be a relapse and the best option for the treatment would be to give drugs every day or in short intervals until the appearance of a new acute episode. The author also emphasize the amount of knowledge one can acquire with the study of well documented cases reported by early researchers. |
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Some comments about a case reported by Wade and Rodrigues In the 30's.Alguns comentários acerca de um caso relatado por Wade e Rodrigues nos anos 30Reação reversarecidivaterapêuticareversal reactionrelapsetherapeuticsWADE and RODRIGUES reported a leprosy case who was followed up during a period of eight years (1932-1940). Initially the patient was thought to be a minor tuberculoid that evolved rapidly and transformed into a major tuberculoid form. After a period of almost two years without manifestation of the disease he presented new and more severe reactional episodes which later become bullous. The case was considered borderline by its evolution, features of the lesions and bacterial findings. The author considered this case as a reactional one since the beginning and commented also its evolution and clinical and bacteriological aspects. He called attention to the regression of the lesions and the disappearance of bacilli without therapeutic influence and later the occurrence of new outbreaks and reappearance of bacilli, even after a large period of time. This report permitted to elaborate an hypothesis in which the bacilli in reactional borderline cases disappear in most part due to the action of the immune system of the host in contrast with reactional tuberculoid cases in which there is a total destruction of bacilli, therefore, the new outbreaks are caused by multiplication of persisters. Confirmation of this hypothesis could have therapeutic implications. MDT/ WHO would be unable to prevent new reactional episodes since the bacterial multiplication occurs out of the period of drug activity. If so, reversal reaction that occur after treatment could actually be a relapse and the best option for the treatment would be to give drugs every day or in short intervals until the appearance of a new acute episode. The author also emphasize the amount of knowledge one can acquire with the study of well documented cases reported by early researchers.Wade e Rodrigues relataram um caso de hansen lase que foi seguido durante um período de 8 anos (1932-1940). Inicialmente o paciente foi considerado ser portador de uma forma tuberculoide minor, que evoluiu rapidamente e se transformou em uma forma tuberculoide major. Após um período de quase 2 anos sem manifestação da doença, ele apresentou novos e mais graves episódios reacionais que mais tarde se tomaram bolhosos. O caso foi considerado "Borderline" pela evolução característica das lesões e resultado da baciloscopia. O autor considerou este caso como um caso reacional desde o início e comentou também seus aspectos evolutivos, clínicos e bacteriológicos. Ele chamou a atenção para regressão das lesões e o desaparecimento dos bacilos sem influência da terapêutica e mais tarde ocorrência de novos surtos e reaparecimento de bacilos, mesmo após um longo período de tempo. Este relato permitiu elaborar uma hipótese na qual os bacilos em casos "Borderline" reacionais desaparecem na sua major parte devido à ação do sistema imune do hospedeiro diferente dos casos tuberculoides reacionais nos quais há uma destruição total dos bacilos, e por isso os novos surtos são causados pormultiplicação de bacilos persistentes. A confirmação desta hipótese poderia ter implicações terapêuticas. A PQT/OMS seria incapaz de evitar novos episódios reacionais quando a multiplicação bacteriana ocorrer fora do período da atividade da droga. Se isso for assim a reação reversa que ocorre após o tratamento poderia realmente ser uma recidiva e a melhor opção para o tratamento seria dar as drogas todos os dias, ou em intervalos curtos até o aparecimento de um episódio agudo. O autor também enfatiza quanto nsinamento pode ser adquirido com o estudo dos casos bem documentados relatados pelos antigos pesquisadores.Instituto Lauro de Souza Lima da Secretaria de Estado da Saúde de São Paulo1995-06-30info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionAvaliado pelos paresapplication/pdfapplication/pdfhttps://periodicos.saude.sp.gov.br/hansenologia/article/view/3544910.47878/hi.1995.v20.35449Hansenologia Internationalis: leprosy and other infectious diseases; Vol. 20 No. 1 (1995); 29-37Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 20 n. 1 (1995); 29-371982-5161reponame:Hansenologia Internationalis (Online)instname:Instituto Lauro de Souza Lima (ILSL)instacron:ILSLporenghttps://periodicos.saude.sp.gov.br/hansenologia/article/view/35449/33870https://periodicos.saude.sp.gov.br/hansenologia/article/view/35449/33871OPROMOLLA, Diltor V. A.info:eu-repo/semantics/openAccess2021-06-08T03:19:28Zoai:ojs.periodicos.saude.sp.gov.br:article/35449Revistahttps://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:2021-06-08T03:19:28Hansenologia Internationalis (Online) - Instituto Lauro de Souza Lima (ILSL)false |
dc.title.none.fl_str_mv |
Some comments about a case reported by Wade and Rodrigues In the 30's. Alguns comentários acerca de um caso relatado por Wade e Rodrigues nos anos 30 |
title |
Some comments about a case reported by Wade and Rodrigues In the 30's. |
spellingShingle |
Some comments about a case reported by Wade and Rodrigues In the 30's. OPROMOLLA, Diltor V. A. Reação reversa recidiva terapêutica reversal reaction relapse therapeutics |
title_short |
Some comments about a case reported by Wade and Rodrigues In the 30's. |
title_full |
Some comments about a case reported by Wade and Rodrigues In the 30's. |
title_fullStr |
Some comments about a case reported by Wade and Rodrigues In the 30's. |
title_full_unstemmed |
Some comments about a case reported by Wade and Rodrigues In the 30's. |
title_sort |
Some comments about a case reported by Wade and Rodrigues In the 30's. |
author |
OPROMOLLA, Diltor V. A. |
author_facet |
OPROMOLLA, Diltor V. A. |
author_role |
author |
dc.contributor.author.fl_str_mv |
OPROMOLLA, Diltor V. A. |
dc.subject.por.fl_str_mv |
Reação reversa recidiva terapêutica reversal reaction relapse therapeutics |
topic |
Reação reversa recidiva terapêutica reversal reaction relapse therapeutics |
description |
WADE and RODRIGUES reported a leprosy case who was followed up during a period of eight years (1932-1940). Initially the patient was thought to be a minor tuberculoid that evolved rapidly and transformed into a major tuberculoid form. After a period of almost two years without manifestation of the disease he presented new and more severe reactional episodes which later become bullous. The case was considered borderline by its evolution, features of the lesions and bacterial findings. The author considered this case as a reactional one since the beginning and commented also its evolution and clinical and bacteriological aspects. He called attention to the regression of the lesions and the disappearance of bacilli without therapeutic influence and later the occurrence of new outbreaks and reappearance of bacilli, even after a large period of time. This report permitted to elaborate an hypothesis in which the bacilli in reactional borderline cases disappear in most part due to the action of the immune system of the host in contrast with reactional tuberculoid cases in which there is a total destruction of bacilli, therefore, the new outbreaks are caused by multiplication of persisters. Confirmation of this hypothesis could have therapeutic implications. MDT/ WHO would be unable to prevent new reactional episodes since the bacterial multiplication occurs out of the period of drug activity. If so, reversal reaction that occur after treatment could actually be a relapse and the best option for the treatment would be to give drugs every day or in short intervals until the appearance of a new acute episode. The author also emphasize the amount of knowledge one can acquire with the study of well documented cases reported by early researchers. |
publishDate |
1995 |
dc.date.none.fl_str_mv |
1995-06-30 |
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/35449 10.47878/hi.1995.v20.35449 |
url |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/35449 |
identifier_str_mv |
10.47878/hi.1995.v20.35449 |
dc.language.iso.fl_str_mv |
por eng |
language |
por eng |
dc.relation.none.fl_str_mv |
https://periodicos.saude.sp.gov.br/hansenologia/article/view/35449/33870 https://periodicos.saude.sp.gov.br/hansenologia/article/view/35449/33871 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf 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. 20 No. 1 (1995); 29-37 Hansenologia Internationalis: hanseníase e outras doenças infecciosas; v. 20 n. 1 (1995); 29-37 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_ |
1796797579663507456 |