TY - JOUR KW - Infections KW - investigations KW - Leprosy reactions KW - Pregnancy KW - Steroids KW - triggers AU - Muddebihal A AU - Sardana K AU - Khurana A AU - Ahuja A AU - Singh I AB -
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.
BT - Tropical doctor C1 -https://www.ncbi.nlm.nih.gov/pubmed/37920941
DA - 11/2023 DO - 10.1177/00494755231210724 J2 - Trop Doct LA - eng N2 -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.
PY - 2023 EP - 494755231210724 T2 - Tropical doctor TI - Time to revisit the purported link of leprosy reactions with infective triggers: An unnecessary economic burden for patients. SN - 1758-1133 ER -