ArticlePLoS neglected tropical diseases2010
Granulomatous reactivation during the course of a leprosy infection: reaction or relapse.
Article in PLoS neglected tropical diseases, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Dynamics of Th1/Th17 responses and antimicrobial pathways in leprosy skin lesions.The Journal of clinical investigation · 2025Article
- Leprosy in the 21st century: a comprehensive review of immunological mechanisms, diagnosis, and treatment.Revista do Instituto de Medicina Tropical de Sao Paulo · 2025Review
- Leprosy.Nature reviews. Disease primers · 2024Review
- Role of histopathological, serological and molecular findings for the early diagnosis of treatment failure in leprosy.BMC infectious diseases · 2024Article
- Catastrophic ocular complications in leprosy: a case report.The Pan African medical journal · 2023Article
- Severe type 1 upgrading leprosy reaction in a renal transplant recipient: a paradoxical manifestation associated with deficiency of antigen-specific regulatory T-cells?BMC infectious diseases · 2017Article
- Article
- Examining ERBB2 as a candidate gene for susceptibility to leprosy (Hansen's disease) in Brazil.Memorias do Instituto Oswaldo Cruz · 2014Article
- Hypopigmented Skin Lesions with Doubtful/Minimal Sensory Impairment: A Histopathology-Based Analysis.Indian dermatology online journalArticle
- Laboratory and functional tests in leprosy diagnosis: a practical guide for clinical decision-making.Anais brasileiros de dermatologiaReview
Corrections and comments
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Authors and funding
9 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeprosy is a chronic granulomatous infectious disease and is still endemic in many parts of the world. It causes disabilities which are the consequence of nerve damage. This damage is in most cases the result of immunological reactions.
objectivesTo investigate the differences between a type 1 leprosy (reversal) reaction and relapse on using histopathology.
methodsThe histopathological changes in 167 biopsies from 66 leprosy patients were studied. The patients were selected when their sequential biopsies demonstrated either different patterns or maintained the same pattern of granulomatous reaction over more than two years during or after the treatment of leprosy.
resultsIn 57 of the patients studied, a reactivation was seen which coincided with a decrease in the bacteriological index (BI), suggesting that this reactivation (reversal reaction or type 1 leprosy reaction) coincides with an effective capacity for bacteriological clearance. In nine patients, an increase of the bacteriologic index (IB) or persistence of solid bacilli occurred during the reactivation, indicating proliferative activity, suggestive of a relapse. The histopathological aspects of the granulomas were similar in both groups.
conclusionBacterioscopy provided the only means to differentiate a reversal reaction from a relapse in patients with granulomatous reactivation. The type 1 leprosy reaction may be considered as a part effective immune reconstitution (reversal, upgrading reaction) or as a mere hypersensitivity reaction (downgrading reaction) in a relapse.
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