Anaemia, iron‐related measurements and erythropoietin levels in untreated patients with active leprosy

Abstract

The mechanisms responsible for anaemia in leprosy were studied prior to the institution of therapy in 56 patients with active disease. Haematological indices, iron-related measurements, inflammatory markers and erythropoietin levels were assessed, with bone-marrow studies being performed on anaemic patients. Anaemia was more common in the patients with lepromatous leprosy (85.7%) than it was in the rest of the group (19%). The lepromatous group exhibited the disordered iron transport of the anaemia of chronic disorders in that they had a significantly lower mean serum iron level (P less than 0.05), and a mildly raised serum ferritin concentration. Anaemic lepromatous patients also showed a blunted erythropoietin response compared with controls with non-inflammatory anaemia. A subgroup of five anaemic subjects displayed apparently adequate transport of iron to the erythroid marrow (normal percentage transferrin saturations and appropriate sideroblast counts) and the blunted erythropoietin response appeared to be the dominant factor in the pathogenesis of their anaemia. Analysis of inflammatory markers revealed that while the erythrocyte sedimentation rate was very high in the lepromatous subjects, there was no concomitant rise in C-reactive protein concentration. This suggests the presence of a disordered cytokine-mediated acute phase response in the condition.

Increased hepcidin expression in multibacillary leprosy

“…Lapinsky et al (1992) reported the occurrence of anaemia in MB patients and classified this anaemia as AI on the basis of decreased serum iron levels and mild increases in serum ferritin concentrations.…”

“…Anaemia is a common finding in patients presenting with MB leprosy (Sher et al 1981, Lapinsky et al 1992, Jain et al 1995, Rea 2001. However, the exact mechanism underlying the reduction in serum iron and the effect of reduced iron levels on leprosy are not well understood.…”

Leprosy: a review of laboratory and therapeutic aspects - Part 2

“…99 Lipid antigens are responsible for false positive reactions for syphilis. 100 The concentration of C-reactive protein is significantly high in patients with ENL and arthritis compared to those without arthritis.…”

Faktor Risiko Anemia pada Pasien Kusta Anak dalam terapi MDT (Multi Drug Therapy)

“…Gangguan terhadap respon eritropoietin tampaknya menjadi faktor dominan sebagai patogenesis terjadinya anemia pada kelompok ini. 19 Dari seluruh faktor risiko yang diteliti hanya lama terapi ≥3 bulan yang bermakna terhadap terjadinya anemia. Penelitian sebelumnya melaporkan onset anemia terjadi saat 3 bulan awal terapi.…”