TY - JOUR
KW - Hemophagocytic lymphohistiocytosis
KW - Leprosy
KW - Type 2 reaction
AU - Madegowda SB
AU - Kakrannaya MP
AU - Kalegowda D
AU - Naidu HM
AB - <jats:p>Leprosy, a chronic mycobacterial disease, is caused by the acid-fast bacillus <jats:italic toggle="yes">Mycobacterium leprae</jats:italic>. The clinical manifestations of this disease depend on the host’s immunity against <jats:italic toggle="yes">M. leprae</jats:italic>. Hemophagocytic lymphohistiocytosis (HLH) is a rare complication that has been reported in association with leprosy. The acquired form of HLH is mainly caused by infections (including various viruses, bacteria, fungi, and parasites), drugs, malignancies, and autoimmune diseases. <jats:italic toggle="yes">Mycobacterium</jats:italic>-triggered HLH has been reported in recent times; however, very few cases have been associated with leprosy. HLH is a rapidly fatal condition with a mortality rate in adults exceeding 50%. Unless an early diagnosis is made and prompt intervention with high-dose steroids and immunoglobulins is undertaken, the mortality rate remains high. Furthermore, the clinical presentation of HLH often coincides with primary sepsis, leading to the withholding of immunosuppressants, which further aggravates the condition. Early diagnosis and prompt intervention in this rare condition are essential to prevent mortality. We describe a case of lepromatous leprosy in a type II reaction on multibacillary-multi-drug therapy treatment, with an unusual, complicated course, characterized by unexplained persistent fever, organomegaly, bicytopenia, and elevated levels of inflammatory markers.</jats:p>
BT - Clinical Dermatology Review
DO - 10.4103/cdr.cdr_188_24
IS - 4
LA - ENG
M3 - Case Report
N2 - <jats:p>Leprosy, a chronic mycobacterial disease, is caused by the acid-fast bacillus <jats:italic toggle="yes">Mycobacterium leprae</jats:italic>. The clinical manifestations of this disease depend on the host’s immunity against <jats:italic toggle="yes">M. leprae</jats:italic>. Hemophagocytic lymphohistiocytosis (HLH) is a rare complication that has been reported in association with leprosy. The acquired form of HLH is mainly caused by infections (including various viruses, bacteria, fungi, and parasites), drugs, malignancies, and autoimmune diseases. <jats:italic toggle="yes">Mycobacterium</jats:italic>-triggered HLH has been reported in recent times; however, very few cases have been associated with leprosy. HLH is a rapidly fatal condition with a mortality rate in adults exceeding 50%. Unless an early diagnosis is made and prompt intervention with high-dose steroids and immunoglobulins is undertaken, the mortality rate remains high. Furthermore, the clinical presentation of HLH often coincides with primary sepsis, leading to the withholding of immunosuppressants, which further aggravates the condition. Early diagnosis and prompt intervention in this rare condition are essential to prevent mortality. We describe a case of lepromatous leprosy in a type II reaction on multibacillary-multi-drug therapy treatment, with an unusual, complicated course, characterized by unexplained persistent fever, organomegaly, bicytopenia, and elevated levels of inflammatory markers.</jats:p>
PB - Ovid Technologies (Wolters Kluwer Health)
PY - 2025
SP - 372
EP - 374
T2 - Clinical Dermatology Review
TI - Hemophagocytic Lymphohistiocytosis in Leprosy: A Rare and Life-threatening Complication
UR - https://journals.lww.com/cddr/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=ArticleViewer&an=02006588-202510000-00013
VL - 9
SN - 2542-551X, 2542-5528
ER -