01670nas a2200241   4500000000100000008004100001260001200042653001500054653001900069653002200088653001400110653001300124653001300137100001700150700001400167700001400181700001200195700001200207245013000219300002000349520104500369022001401414       2023                            d  c11/202310aInfections10ainvestigations10aLeprosy reactions10aPregnancy10aSteroids10atriggers1 aMuddebihal A1 aSardana K1 aKhurana A1 aAhuja A1 aSingh I00aTime to revisit the purported link of leprosy reactions with infective triggers: An unnecessary economic burden for patients.  a4947552312107243 a<p>Existing literature on factors triggering leprosy reactions is based only on case reports and case series, and thus probably gives a biased view. We undertook a case-control study to investigate such purported trigger factors in 42 leprosy reaction patients and 40 non-reactional controls, and the cost of investigations required for the same. Detailed history, clinical evaluation and investigations for triggers were carried out. Infections (typhoid, dental caries) were the most common triggers found, followed by pregnancy. Trigger factors were commoner in the type 2 reaction (T2R) group compared to type 1 (T1R) reaction group. There was however no statistical difference between the two groups. The average estimated cost of investigations was higher in the reactional group and this difference was statistically significant. Hence, except for essential investigations required for initiating steroids, an extensive battery of investigations is unjustified unless the medical history suggests a definitive infective trigger.</p>
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