2010
DOI: 10.1371/journal.pntd.0000921
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Granulomatous Reactivation during the Course of a Leprosy Infection: Reaction or Relapse

Abstract: BackgroundLeprosy is a chronic granulomatous infectious disease and is still endemic in many parts of the world. It causes disabilities which are the consequence of nerve damage. This damage is in most cases the result of immunological reactions.ObjectivesTo investigate the differences between a type 1 leprosy (reversal) reaction and relapse on using histopathology.MethodsThe histopathological changes in 167 biopsies from 66 leprosy patients were studied. The patients were selected when their sequential biopsi… Show more

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Cited by 14 publications
(9 citation statements)
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“…Type 1 downgrading reactions can be associated with slow transition towards the lepromatous pole caused by diminishing cell mediated immunity. This is usually seen with relapsed leprosy or where treatment compliance has been poor . Type 1 reversal reactions occur where T‐cell mediated immunity increases rapidly and disease shifts towards the tuberculoid pole with accelerated granulomatous inflammation.…”
Section: Demographic and Key Clinical Information For Reviewed Cases mentioning
confidence: 99%
See 1 more Smart Citation
“…Type 1 downgrading reactions can be associated with slow transition towards the lepromatous pole caused by diminishing cell mediated immunity. This is usually seen with relapsed leprosy or where treatment compliance has been poor . Type 1 reversal reactions occur where T‐cell mediated immunity increases rapidly and disease shifts towards the tuberculoid pole with accelerated granulomatous inflammation.…”
Section: Demographic and Key Clinical Information For Reviewed Cases mentioning
confidence: 99%
“…This is usually seen with relapsed leprosy or where treatment compliance has been poor. 8 Type 1 reversal reactions occur where T-cell mediated immunity increases rapidly and disease shifts towards the tuberculoid pole with accelerated granulomatous inflammation. In type 1 reversal reactions, patients present with rapidly deteriorating neurology associated with neuritis and oedema of skin lesions.…”
Section: Table 1 Demographic and Key Clinical Information For Reviewementioning
confidence: 99%
“…In regards to MB forms, individuals with a higher bacillary index (BI>3) at pretreatment and negative LST are at higher risk for relapse. Moreover, accurate relapse diagnosis and identification of reactional states are crucial for preventing aggravation of neural damage as well as continued disease transmission in some situations [ 7 , 8 ].…”
Section: Introductionmentioning
confidence: 99%
“…The few cases of transplant recipients with leprosy reactions reported in the literature represented challenging diagnosis and management [2, 10, 14, 20]. The development of a reaction was in general linked to tapering of immunosuppression, although this was not true for every case [10, 21] and the present case report.…”
Section: Discussionmentioning
confidence: 66%