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Risk factors for erythema nodosum leprosum.
Int J Lepr Other Mycobact Dis. 1999 Sep; 67(3):270-8.IJ

Abstract

A retrospective study of new borderline lepromatous and lepromatous patients reporting for multidrug therapy (MDT) for leprosy at the Anandaban Leprosy Hospital, Kathmandu, Nepal, over an 8-year period was conducted to determine the prevalence of erythema nodosum leprosum (ENL), the time and frequency of reactions, and clinical and laboratory parameters associated with ENL. An overall prevalence of ENL in this cohort of 19% was found. One third of these reactions occurred in patients before MDT was given, one third in the first 6 months and one third after 6 months of treatment. Nearly 1 in 10 of the ENL reactions occurred in patients who had completed 2 years of MDT; 45% of patients with ENL had more than one episode. Data collected at the patients' first presentation was used to identify four major risk factors. Patients with lepromatous disease, skin infiltration or a bacterial index (BI) of > 4+ were at significantly increased risk. Patients older than 40 were at significantly decreased risk of ENL. There was a linear relationship in the risk of ENL with an increasing BI and an inverse relationship to increasing age. These observations should enable clinicians to recognize patients at first presentation who will be likely to develop ENL.

Authors+Show Affiliations

Mycobacterial Research Laboratory, Anandaban Leprosy Hospital, Kathmandu, Nepal.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

10575406

Citation

Manandhar, R, et al. "Risk Factors for Erythema Nodosum Leprosum." International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association, vol. 67, no. 3, 1999, pp. 270-8.
Manandhar R, LeMaster JW, Roche PW. Risk factors for erythema nodosum leprosum. Int J Lepr Other Mycobact Dis. 1999;67(3):270-8.
Manandhar, R., LeMaster, J. W., & Roche, P. W. (1999). Risk factors for erythema nodosum leprosum. International Journal of Leprosy and Other Mycobacterial Diseases : Official Organ of the International Leprosy Association, 67(3), 270-8.
Manandhar R, LeMaster JW, Roche PW. Risk Factors for Erythema Nodosum Leprosum. Int J Lepr Other Mycobact Dis. 1999;67(3):270-8. PubMed PMID: 10575406.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for erythema nodosum leprosum. AU - Manandhar,R, AU - LeMaster,J W, AU - Roche,P W, PY - 1999/11/27/pubmed PY - 1999/11/27/medline PY - 1999/11/27/entrez SP - 270 EP - 8 JF - International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association JO - Int J Lepr Other Mycobact Dis VL - 67 IS - 3 N2 - A retrospective study of new borderline lepromatous and lepromatous patients reporting for multidrug therapy (MDT) for leprosy at the Anandaban Leprosy Hospital, Kathmandu, Nepal, over an 8-year period was conducted to determine the prevalence of erythema nodosum leprosum (ENL), the time and frequency of reactions, and clinical and laboratory parameters associated with ENL. An overall prevalence of ENL in this cohort of 19% was found. One third of these reactions occurred in patients before MDT was given, one third in the first 6 months and one third after 6 months of treatment. Nearly 1 in 10 of the ENL reactions occurred in patients who had completed 2 years of MDT; 45% of patients with ENL had more than one episode. Data collected at the patients' first presentation was used to identify four major risk factors. Patients with lepromatous disease, skin infiltration or a bacterial index (BI) of > 4+ were at significantly increased risk. Patients older than 40 were at significantly decreased risk of ENL. There was a linear relationship in the risk of ENL with an increasing BI and an inverse relationship to increasing age. These observations should enable clinicians to recognize patients at first presentation who will be likely to develop ENL. SN - 0148-916X UR - https://www.unboundmedicine.com/medline/citation/10575406/Risk_factors_for_erythema_nodosum_leprosum_ DB - PRIME DP - Unbound Medicine ER -