A prospective study of clinical profile of type 2 lepra-reaction, clinical responses to treatment with thalidomide and seroprevalence of HIV in reactional patients
Keywords:
leprosy, lepra reactionAbstract
Objective The purpose of the present study is to know the prevalence of components of Type2 lepra reaction, clinical response to Thalidomide for Type 2 reaction during Acute Therapy Period and sero prevalence of HIV in the reactional patient. Methods All patients were hospitalized and Thalidomide capsules 100mg three times a day for seven days were given under supervision. The clinical response assessment was made and recorded for the following clinical parameters at 48 hours, 98 hours and on the 7th day. Fever, malaise and anorexia, ENL count, arthritis/ arthralgia, orchitis, nerve tenderness. Results Among the 52 patients of type 2 lepra-reaction patients, 27 patients fulfilled the selection criteria to observe the clinical response to thalidomide during the Acute Therapy Period (ATP). There were five female patients (18.5%). The total no of males was 22 (81.5%). Among the total 27 patients, 23 (85.2% patients showed partial improvement and 4 (14-8%) patients showed striking improvement at 48 hours. At 96 hours the number of partial improvement group patients decreased to 7 (25.9%) and the striking improvement group rose to 20 (74.1%) but no total response. On the 7th day, only one (3.7%) patient remained in the partial improvement group, while 21 (7.8%) were in the striking group. Five patients (18.5%) showed a total response to thalidomide. Conclusion A total of 27 patients enrolled, on the seventh day, 5 (18.5%) patients showed complete clearance of reactional symptoms. 21(77.8%) patients showed 50 to 99% improvement. One (3.8%) patient showed only 25% improvement and was considered a treatment failure.References
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