Adrenal cortical function and reserve in lepromatous leprosy

Area of Science:

• Endocrinology
• Infectious Diseases
• Immunology

Background:

• Lepromatous Leprosy is a chronic infectious disease affecting the immune system.
• Adrenal insufficiency can be a complication of chronic infections.
• Assessing adrenal function is crucial for managing patients with Lepromatous Leprosy.

Purpose of the Study:

• To evaluate the adrenal cortical reserve in patients with chronic Lepromatous Leprosy.
• To compare adrenal function between non-reactional and reactional states of Lepromatous Leprosy.
• To determine if Lepromatous Leprosy affects the hypothalamic-pituitary-adrenal (HPA) axis.

Main Methods:

• Serum cortisol levels were measured using radioimmunoassay in 22 Lepromatous Leprosy patients (17 non-reactional, 5 reactional) and normal controls.
• Basal cortisol levels were assessed in the morning (8:00 AM).
• Adrenal stimulation tests were performed using ACTH gel or insulin-induced hypoglycemia to assess cortisol response.

Main Results:

• Basal serum cortisol was slightly lower in non-reactional patients and slightly higher in reactional patients compared to normal controls, with no statistical significance.
• The percentage increase in cortisol after stimulation was significantly reduced in both non-reactional and reactional Lepromatous Leprosy patients.
• No significant difference in adrenal reserve was observed between the reactional and non-reactional groups.

Conclusions:

• Adrenal cortical reserve is compromised in patients with Lepromatous Leprosy.
• This impairment in adrenal function is present in both reactional and non-reactional states.
• The findings suggest a potential role for HPA axis dysfunction in the pathophysiology or complications of Lepromatous Leprosy.