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Lepromatous Reaction Type II: Clinical and Laboratory Aspects
Sueli Carneiro1,2, Fernanda K Nakasato1, Vivian Balassiano1
1The Sector of Dermatology and Post-Graduation Course, University Hospital and School of Medicine, Federal University of Rio de Janeiro, Brazil.
Type II lepromatous reactions, a Gell & Coombs Type III hypersensitivity, are common in lepromatous borderline and lepromatous lepromatous leprosy patients. Understanding clinical and lab findings aids in preventing leprosy complications.
Area of Science:
- Immunology
- Dermatology
- Infectious Diseases
Background:
- Type II lepromatous reaction involves an exaggerated immune response in leprosy patients.
- This reaction is a Gell & Coombs Type III hypersensitivity, more prevalent in lepromatous borderline (LB) and lepromatous lepromatous (LL) forms of leprosy.
- Clinical and laboratory manifestations are crucial for managing leprosy complications.
Purpose of the Study:
- To investigate the clinical and laboratory features of Type II lepromatous reactions.
- To establish correlations between clinical and laboratory findings in these reactions.
- To inform preventive and therapeutic strategies for leprosy.
Main Methods:
- Retrospective review of medical records of leprosy patients at HUCFF/UFRJ over 12 years.
- Data collection included demographic, clinical, and laboratory information from 133 patients with Type II reaction.
- Histopathologic confirmation and Mitsuda reaction tests were performed.
Main Results:
- Lepromatous patients (LP) showed higher rates of positive bacilloscopy (73.91%) compared to borderline patients (BP) (26.9%).
- Erythema nodosum leprosum (ENL) was more frequent in LP (71%) than BP (44%).
- Erythema multiforme (EM) occurred in 32% of BP and 13% of LP, while Lucio phenomenon (LPh) was observed in 23.6% of BP and 15.4% of LP.
Conclusions:
- Clinical and laboratory presentations of Type II reactions vary between leprosy subtypes.
- Identifying these presentations is vital for timely intervention.
- Effective management can mitigate leprosy-related disabilities and stigma.
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