02639nas a2200421   4500000000100000008004100001260001300042653001500055653001000070653000900080653001100089653001200100653001100112653001200123653002400135653002500159653002500184653000900209653001600218653002100234653002400255653002100279100001400300700001300314700001500327700001500342700001400357700001400371700001500385700001300400245010000413856004100513300001100554490000700565050001600572520161500588022001402203       1991                            d  c1991 Dec10aAdolescent10aAdult10aAged10aFemale10aFingers10aHumans10aleprosy10aLeprosy, Borderline10aLeprosy, lepromatous10aLeprosy, Tuberculoid10aMale10aMiddle Aged10aReflex, Abnormal10aRegional Blood Flow10aVasomotor System1 aAbbot N C1 aBeck J S1 aSamson P D1 aButlin C R1 aBrown R A1 aForster A1 aGrange J M1 aCree I A00aImpairment of fingertip vasomotor reflexes in leprosy patients and apparently healthy contacts.  uhttp://ila.ilsl.br/pdfs/v59n4a01.pdf  a537-470 v59  aABBOTT 19913 a<p>Fingertip blood-flow velocity and its control by vasomotor reflexes were studied in leprosy patients and in healthy controls with a laser Doppler flowmeter. In newly registered patients, the flow was significantly lower than in the healthy controls, and even lower values were recorded in the long-standing patients with lower limb ulcers and/or deformity. The newly registered patients showed substantially impaired vasomotor reflex responses in the fingertips to cold challenge of the opposite hand or deep inspiratory gasp. Low blood flow and impairment of vasomotor reflexes were more prominent in those leprosy patients who showed clinical evidence of neuropathy and/or histological evidence of reaction in a punch biopsy of leprosy skin lesions. This aspect of dysautonomia to cold challenge was particularly prominent in apparently healthy, fully treated ex-patients. There was an unexpectedly high prevalence of impairment of vasomotor reflexes in newly registered and apparently healthy, adequately treated leprosy patients. The method is very sensitive, and it remains to be established whether the lesions it detects are nonprogressive residues, or previous nerve damage, or an indication of on-going nerve damage. A minority of leprosy contacts showed impairment of vasomotor reflexes. Those with two or more affected fingers were more likely to have had a higher level of exposure to Mycobacterium leprae than those with one or no affected fingers. The cause of this unexpected impairment of fingertip vasomotor reflexes in a minority of leprosy control workers has not yet been determined.</p>  a0148-916X