01432nas a2200157   4500000000100000008004100001100001500042700001300057700001200070700001700082245008800099856008300187300001200270490000700282520098500289       2021                            d1 aMahajan RS1 aNinama K1 aShah AR1 aMarfatia Y S00aDeep Vein Thrombosis in Refractory Erythema Nodosum Leprosum: A Report of Two Cases  uhttp://www.ijl.org.in/2021-apr-jun/9-%20RS%20Mahajan%20et%20al%20(211-220).pdf  a211-2200 v933 aHansen's disease is a chronic granulomatous disease caused by Mycobacterium leprae. Acute exacerbations
termed as lepra reactions often mark the course of the disease. These are of two types - Type 1 or Reversal
Reaction and Type 2 or Erythema Nodosum Leprosum (ENL). Chronic recurrent ENL is a frequently
encountered, difficult to treat condition which is usually managed with systemic corticosteroids, increasing the
dose of clofazimine, non-steroidal anti-inflammatory drugs, cyclosporine A, azathioprine, pentoxyphylline,
mycophenolate mofetil, methotrexate and intravenous immunoglobulin (IVIG). Thalidomide is the drug of
choice in most instances. Thrombo-embolism is a rare but known complication of thalidomide therapy
especially when combined with corticosteroids or chemotherapeutic agents. Herein we report 2 cases of
refractory ENL developing Deep Vein Thrombosis (DVT) while on concomitant therapy with thalidomide and
corticosteroids for the control of ENL.