02123nas a2200193   4500000000100000008004100001653001800042653001200060653005100072100001200123700001400135700001300149700001400162245008100176856005100257300001400308490000700322520160000329       2018                            d10aAdrenal gland10aleprosy10aLow dose adrenocorticotrophin stimulation test1 aGupta A1 aSharma PK1 aGarga UC1 aSharma LK00aAdrenal cortical function and adrenal volume in leprosy: A study of 40 cases  uhttps://leprosyreview.org/article/89/2/14-8157  a148–1570 v893 a<p>Background: Leprosy is a chronic infectious disease predominantly affecting peripheral nerves and skin. Whether Mycobacterium leprae infection affects adrenal structure and/or its function remains to be fully elucidated.<br />
Methods: Forty untreated leprosy patients and 10 healthy controls were evaluated for adrenal function and morphology by measuring the basal and stimulated cortisol levels after a low dose adrenocorticotrophin stimulation test (LDT) and contrast enhanced computed tomography (CECT) respectively.<br />
Results: The basal cortisol levels were in the normal range in leprosy patients and did not change significantly with the type of leprosy or presence of reaction (P . 0·05). Peak cortisol response to LDT was ,550 nmol/L at 30 and 60 minutes in 21 (52·5%) leprosy cases [two (15·4%) paucibacillary (PB) cases and 19 (70·4%) multibacillary (MB) cases] indicating significant subclinical adrenal insufficiency in multibacillary cases (P,0·001). This depressed response was unrelated to the presence or type of reaction. The mean adrenal gland volume was found to be marginally larger in leprosy patients (both PB and MB) than the controls, although, not statistically significant (P . 0·05). All the leprosy patients had normal morphology of the adrenal glands.<br />
Conclusions: There is a relative adrenocortical hypofunction in patients with multibacillary leprosy without any dimensional or structural change in adrenal&nbsp; glands. Thus, these patients may have suboptimal responses during periods of stress from infection, surgery or otherwise.</p>