Die Lepra als Thesaurismose

Leprosy: pathogenesis updated

“…In summary, lepromatous leprosy is an infectious disease caused by M. leprae and a metabolic disorder secondary to the dysfunction of lysosomal phospholipases in “Mitsuda‐negative macrophages.” Lepra cells are not friendly hosts, as they eventually evolve into bacterial cemeteries. Lepromatous leprosy may be considered a phospholipid deposit disease or post‐bacillar tesaurismosis .6 , 48 Ziehl–Neelsen stain shows that the lipid envelope reacts like lipofuchsin; it is diagnostic, but not specific and does not reflect the viability of M. leprae .…”

“…In Mitsuda‐positive patients, these cells form epithelioid granulomas, but in Mitsuda‐negative patients they produce virchowcytic granulomas. In the latter, the lepra cells or virchowcytes are macrophages that, having partially digested the bacillar phospholipids, lead to a metabolic disease (tesaurismosis) .6 …”