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Leprosy nephropathy: a review of clinical and histopathological features.

Silva Junior GB, Daher Ede F, Pires Neto Rda J, Pereira ED, Meneses GC, Araújo SM, Barros EJ - Rev. Inst. Med. Trop. Sao Paulo (2015 Jan-Feb)

Bottom Line: The clinical presentation is variable and is determined by the host immunologic system reaction to the bacilli.During the course of the disease there are the so called reactional states, in which the immune system reacts against the bacilli, exacerbating the clinical manifestations.Prednisone and non-steroidal anti-inflammatory drugs may be used to control acute immunological episodes.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, Master in Collective Health, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil.

ABSTRACT
Leprosy is a chronic disease caused by Mycobacterium leprae, highly incapacitating, and with systemic involvement in some cases. Renal involvement has been reported in all forms of the disease, and it is more frequent in multibacillary forms. The clinical presentation is variable and is determined by the host immunologic system reaction to the bacilli. During the course of the disease there are the so called reactional states, in which the immune system reacts against the bacilli, exacerbating the clinical manifestations. Different renal lesions have been described in leprosy, including acute and chronic glomerulonephritis, interstitial nephritis, secondary amyloidosis and pyelonephritis. The exact mechanism that leads to glomerulonephritis in leprosy is not completely understood. Leprosy treatment includes rifampicin, dapsone and clofazimine. Prednisone and non-steroidal anti-inflammatory drugs may be used to control acute immunological episodes.

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Pathophysiology of renal involvement in leprosy. AKI = acute kidney injury;CKD = chronic kidney disease.
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f01: Pathophysiology of renal involvement in leprosy. AKI = acute kidney injury;CKD = chronic kidney disease.

Mentions: The exact mechanism that leads to glomerulonephritis in leprosy is notcompletely understood. The M. leprae may be directly involved in renalinjury and it has already been detected in glomeruli of infected patients. Theglomerular lesion is probably caused by immunologic mechanism, with complement decreaseand immune complexes deposition in glomerular basement membrane, subendothelial andsubepithelial space, detected by electronic microscopy19,41,48. Some studies have also detected mesangial proliferation and the presence of IgAin the mesangial area53. The pathophysiology of renal involvement in leprosy is illustrated in Fig. 1.


Leprosy nephropathy: a review of clinical and histopathological features.

Silva Junior GB, Daher Ede F, Pires Neto Rda J, Pereira ED, Meneses GC, Araújo SM, Barros EJ - Rev. Inst. Med. Trop. Sao Paulo (2015 Jan-Feb)

Pathophysiology of renal involvement in leprosy. AKI = acute kidney injury;CKD = chronic kidney disease.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325518&req=5

f01: Pathophysiology of renal involvement in leprosy. AKI = acute kidney injury;CKD = chronic kidney disease.
Mentions: The exact mechanism that leads to glomerulonephritis in leprosy is notcompletely understood. The M. leprae may be directly involved in renalinjury and it has already been detected in glomeruli of infected patients. Theglomerular lesion is probably caused by immunologic mechanism, with complement decreaseand immune complexes deposition in glomerular basement membrane, subendothelial andsubepithelial space, detected by electronic microscopy19,41,48. Some studies have also detected mesangial proliferation and the presence of IgAin the mesangial area53. The pathophysiology of renal involvement in leprosy is illustrated in Fig. 1.

Bottom Line: The clinical presentation is variable and is determined by the host immunologic system reaction to the bacilli.During the course of the disease there are the so called reactional states, in which the immune system reacts against the bacilli, exacerbating the clinical manifestations.Prednisone and non-steroidal anti-inflammatory drugs may be used to control acute immunological episodes.

View Article: PubMed Central - PubMed

Affiliation: School of Medicine, Master in Collective Health, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil.

ABSTRACT
Leprosy is a chronic disease caused by Mycobacterium leprae, highly incapacitating, and with systemic involvement in some cases. Renal involvement has been reported in all forms of the disease, and it is more frequent in multibacillary forms. The clinical presentation is variable and is determined by the host immunologic system reaction to the bacilli. During the course of the disease there are the so called reactional states, in which the immune system reacts against the bacilli, exacerbating the clinical manifestations. Different renal lesions have been described in leprosy, including acute and chronic glomerulonephritis, interstitial nephritis, secondary amyloidosis and pyelonephritis. The exact mechanism that leads to glomerulonephritis in leprosy is not completely understood. Leprosy treatment includes rifampicin, dapsone and clofazimine. Prednisone and non-steroidal anti-inflammatory drugs may be used to control acute immunological episodes.

Show MeSH
Related in: MedlinePlus