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Histopathological study of ocular erythema nodosum leprosum and post-therapeutic scleral perforation: a case report.

Abstract

Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae , clinically present either as tuberculoid, borderline or lepromatous type. Erythema nodosum leprosum (ENL) is an acute humoral response in the chronic course of lepromatous leprosy. Although very severe ENL reactions are known in systemic leprosy, such severity is rare in ocular tissues. A leprosy uveitis patient suffered from a severe form of post-therapeutic ENL reaction which resulted in perforation of the globe at the site of preexisting subconjunctival leproma. Painful blind eye was enucleated. Histopathological study revealed infiltration of numerous polymorphs and macrophages packed with acid-fast bacilli in the conjunctiva, cornea, ciliary body, ora serrata and sclera. A profuse influx of neutrophils on a background of macrophages packed with M. leprae confirmed the ocular ENL reaction. This case is reported to alert the ophthalmologists to a rare ocular complication of ENL.

More information

Type
Journal Article
Author
Rathinam S R
Khazaei HM
Job C K
Year of Publication
2008
Journal
Indian journal of ophthalmology
Volume
56
Issue
5
Number of Pages
417-9
Date Published
2008 Sep-Oct
Language
eng
ISSN Number
0301-4738
DOI
10.4103/0301-4738.42421
Alternate Journal
Indian J Ophthalmol
Publication Language
eng