Cross Sectional Study of C - Reactive Protein (CRP) in Leprosy and Lepra Reaction

Leprosy is a chronic disease caused by Mycobacterium leprae with varied clinical presentations. Lepra reactions result from sudden changes in immunological response against M. leprae, these are characterized by sudden appearance of signs and symptoms of tissue inflammation. C - reactive protein (CRP) is acute phase reactant and could be useful in monitoring the lepra reactions. The aim of present study was to assess CRP status in leprosy and lepra reaction patients so as to explore the possible utility of CRP as acute phase reactant in lepra reactions. This cross sectional study was conducted at tertiary care centre of SMIMER, Surat, Gujarat, India on newly diagnosed leprosy patients and those on treatment experiencing lepra reaction attending leprosy clinic between June 2017 to September 2018. Cases were clinically classified and treated as per National Leprosy Eradication Programme (NLEP) guidelines. Serum CRP was measured by Latex semiquantitative method. Out of 97 leprosy cases, reactive CRP was found in 37 (38.14%) cases. Reactive CRP was in 18 (40% n=45) cases of Borderline leprosy, and 13 (48.15% n=27) cases of Lepromatous leprosy, 5 (26.32%, n=19) cases of Tuberculoid leprosy, 1 (16.67% n=6) cases of Pure neural leprosy. Among Type 1 Lepra reaction cases, 13 (76.47% n=17) cases had reactive CRP, while among Type 2 reaction cases, 9 (75% n=12) had reactive CRP. Difference of reactive CRP between leprosy and lepra reaction was statistically significant. While the cross sectional study design and small sample size are the limitations of present study. Our data indicates reactive CRP in lepra reaction state might serve as surrogate marker for lepra reaction. Quantitative measurement of CRP along with clinical signs & symptoms could help to categorise severity of lepra reaction. This marker thus needs to be further studied by follow up investigations in statistically significant number of cases.