A STUDY ON THE CLINICAL PROFILES OF PATIENTS WITH LEPRA REACTIONS TYPE 1 AND TYPE 2 REACTIONS COMING TO THE OPD AT TERTIARY CARE CENTRE IN WESTERN UTTAR PRADESH
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 8
Abstract
BACKGROUND Type 1 reaction is a Type IV Hypersensitivity reaction in Borderline leprosy occurring in early treatment, also called reversal reaction affecting those with Borderline leprosy upgrading to tuberculoid type or any patient with unstable cell mediated immunity. Type 2 reaction is a Type III hypersensitivity reaction occurring in Borderline Leprosy (BL) downgrading to Lepromatous Leprosy (LL) late during treatment and is a humoral antibody antigen reaction to immune complexes. Uttar Pradesh still harbors 23% of total leprosy cases reported in India, according to the latest census [1]. Study Design- A longitudinal study carried from the year 2015 to 2018 Setting- Study was conducted at a Tertiary Care Centre in Western Uttar Pradesh. Inclusion Criteria- Patients who voluntarily participated in the study and aged 10 and above were included in the study. Exclusion Criteria- Patients who refused to participate in the study. ObjectivesTo observe the clinical features of the patients with Hansen’s disease Type 1 and Type 2 reaction along with histopathology G6PD analysis for all the patient and rendering treatment accordingly To analyze effectiveness of Center of Disease Control and Prevention recommended therapy over Indian MDT therapy. MATERIALS AND METHODS Patients were included according to the inclusion criteria and all the clinical features were observed and recorded in a pro forma. Basic investigations along with G6PD analysis was done with all 50 patients. CDC therapy was given to all the patients in contrary to the MDT therapy and downgrading of pole with recurrence of reaction was recorded. Patients were followed up accordingly. RESULTS Out of 50 patients 70% of the patients were found to be having Type 2 reaction while 30% patients had Type 1 reaction. 18% patients presented with G6PD deficiency. 10% patients were found to be having resistant tuberculosis along with Hansen’s disease. Only 18% relapse cases observed along with G6PD deficiency. CONCLUSION We concluded that G6PD analysis before starting on Dapsone therapy is mandatory and prevent hemolysis. CDC therapy proves to be the best rather than MDT therapy to prevent recurrences and prevent resistance to Rifampicin in tuberculosis patient as well.
Authors and Affiliations
Pallavi Kashyap D, Ramachandra Reddy D
Keywords
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- EP ID EP410105
- DOI 10.14260/jemds/2018/227
- Views 71
- Downloads 0
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