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Clinical, histopathological and bacteriological study of 52 referral MB cases relapsing after MDT.
Lepr Rev. 2005 Sep; 76(3):241-52.LR

Abstract

Fifty-two BB-LL relapse cases referred to our centre during 1997-2003 were investigated in detail. Twenty-four cases had been treated with extended MB-MDT [until smear negativity (NON-FDT)]. The remaining 28 cases (54%) had received one of the fixed duration regimens (FDT), of whom 11 had 24 months and 6 had 12 months of WHO MB-MDT. Eleven cases had received rifampicin/ofloxacin (RO) treatment. Follow-up slit skin smear reports were available for 41 cases, all but three cases had been smear negative at some point after release from treatment. None of the cases showed any clinical or bacteriological evidence of upgrading, i.e. LL to BT where as downgrading BB to BL occurred in five cases. The duration between cessation of treatment and reappearance of lesions (DCTR) varied from 2 to 15 years. The mean DCTR was longest (9.4 years) for the NON-FDT and 24 months MB-MDT cases. The mean DCTR was significantly lower in the 12 months MB-MDT and RO treated cases (6.8 and 6.2 years, respectively). Four of RO treated cases and four cases with multiple episodes of reaction had DCTR less than 5 years. Inadequate treatment/poor killing of Mycobacterium leprae results in early onset relapse, whereas 'persisting' or 'drug resistant mutants' contribute to late onset relapse.

Authors+Show Affiliations

The Foundation for Medical Research, Worli, Mumbai, India. fmr@vsnl.netNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

16248211

Citation

Shetty, V P., et al. "Clinical, Histopathological and Bacteriological Study of 52 Referral MB Cases Relapsing After MDT." Leprosy Review, vol. 76, no. 3, 2005, pp. 241-52.
Shetty VP, Wakade AV, Ghate SD, et al. Clinical, histopathological and bacteriological study of 52 referral MB cases relapsing after MDT. Lepr Rev. 2005;76(3):241-52.
Shetty, V. P., Wakade, A. V., Ghate, S. D., Pai, V. V., Ganapati, R. R., & Antia, N. H. (2005). Clinical, histopathological and bacteriological study of 52 referral MB cases relapsing after MDT. Leprosy Review, 76(3), 241-52.
Shetty VP, et al. Clinical, Histopathological and Bacteriological Study of 52 Referral MB Cases Relapsing After MDT. Lepr Rev. 2005;76(3):241-52. PubMed PMID: 16248211.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical, histopathological and bacteriological study of 52 referral MB cases relapsing after MDT. AU - Shetty,V P, AU - Wakade,A V, AU - Ghate,S D, AU - Pai,V V, AU - Ganapati,R R, AU - Antia,N H, PY - 2005/10/27/pubmed PY - 2005/11/11/medline PY - 2005/10/27/entrez SP - 241 EP - 52 JF - Leprosy review JO - Lepr Rev VL - 76 IS - 3 N2 - Fifty-two BB-LL relapse cases referred to our centre during 1997-2003 were investigated in detail. Twenty-four cases had been treated with extended MB-MDT [until smear negativity (NON-FDT)]. The remaining 28 cases (54%) had received one of the fixed duration regimens (FDT), of whom 11 had 24 months and 6 had 12 months of WHO MB-MDT. Eleven cases had received rifampicin/ofloxacin (RO) treatment. Follow-up slit skin smear reports were available for 41 cases, all but three cases had been smear negative at some point after release from treatment. None of the cases showed any clinical or bacteriological evidence of upgrading, i.e. LL to BT where as downgrading BB to BL occurred in five cases. The duration between cessation of treatment and reappearance of lesions (DCTR) varied from 2 to 15 years. The mean DCTR was longest (9.4 years) for the NON-FDT and 24 months MB-MDT cases. The mean DCTR was significantly lower in the 12 months MB-MDT and RO treated cases (6.8 and 6.2 years, respectively). Four of RO treated cases and four cases with multiple episodes of reaction had DCTR less than 5 years. Inadequate treatment/poor killing of Mycobacterium leprae results in early onset relapse, whereas 'persisting' or 'drug resistant mutants' contribute to late onset relapse. SN - 0305-7518 UR - https://www.unboundmedicine.com/medline/citation/16248211/Clinical_histopathological_and_bacteriological_study_of_52_referral_MB_cases_relapsing_after_MDT_ L2 - https://medlineplus.gov/mycobacterialinfections.html DB - PRIME DP - Unbound Medicine ER -