02094nas a2200265   4500000000100000008004100001260001300042653001700055653002300072653001200095653001700107100001400124700001300138700001600151700001500167700001200182700001800194700001600212245013400228856009300362300001000455490000800465520134100473022001401814       2013                            d  c2013 Nov10aRisk Factors10aMuldtidrug therapy10aleprosy10aLaboratories1 aAntunes D1 aAraujo S1 aFerreira GP1 aCunha ACSR1 aCosta A1 aGonçalves MA1 aGoulart IMB00aIdentification of clinical, epidemiological and laboratory risk factors for leprosy reactions during and after multidrug therapy.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3970646/pdf/0074-0276-mioc-108-07-00901.pdf  a901-80 v1083 a<p>This cross-sectional retrospective study evaluated 440 leprosy patients; 57% (251/440) had leprosy reactions during and/or after multidrug therapy, 80.5% (202/251) of whom presented with multibacillary leprosy. At diagnosis, positive bacterial index (BI) [odds ratio (OR) = 6.39; 95% confidence interval (CI): 4.1-10.1)] or polymerase chain reaction (PCR) (OR = 9.15; 95% CI: 5.4-15.5) in skin smears, anti-phenolic glycolipid-1 (anti-PGL-1) ELISA (OR = 4.77; 95% CI: 2.9-7.9), leucocytosis (OR = 9.97; 95% CI: 3.9-25.7), thrombocytopenia (OR = 5.72; 95% CI: 2.3-14.0) and elevated lactate dehydrogenase (OR = 2.38; 95% CI: 1.4-4.0) were potential markers for the development of reactions during treatment. After treatment, positive BI (OR = 8.47; 95% CI: 4.7-15.3) and PCR (OR = 6.46; 95% CI: 3.4-12.3) in skin smears, anti-PGL-1 ELISA (OR = 2.25; 95% CI: 1.3-3.9), anaemia (OR = 2.36; 95% CI: 1.2-4.5), leucocytosis (OR = 4.14; 95% CI: 1.5-11.6) and thrombocytopenia (OR = 3.70; 95% CI: 1.3-2.2) were risk factors for the occurrence of reactions during the study period. The identification of groups with an increased risk for developing reactions will allow for the timely development of a treatment plan to prevent nerve damage and, therefore, the appearance of the disabling sequelae associated with the stigma of leprosy.</p>
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