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ENLIST 1: An International Multi-centre Cross-sectional Study of the Clinical Features of Erythema Nodosum Leprosum.

Walker SL, Balagon M, Darlong J, Doni SN, Hagge DA, Halwai V, John A, Lambert SM, Maghanoy A, Nery JA, Neupane KD, Nicholls PG, Pai VV, Parajuli P, Sales AM, Sarno E, Shah M, Tsegaye D, Lockwood DN, Erythema Nodosum Leprosum International STudy Gro - PLoS Negl Trop Dis (2015)

Bottom Line: The treatment of ENL requires immunosuppression, which is often required for prolonged periods of time and may lead to serious adverse effects.ENL and its treatment is associated with increased mortality and economic hardship.The study also provides data on the clinical features of ENL, which can be incorporated into a definition of ENL and used for outcome measures in treatment studies.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.

ABSTRACT
Erythema nodosum leprosum (ENL) is a severe multisystem immune mediated complication of borderline lepromatous leprosy and lepromatous leprosy. ENL is associated with skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. The treatment of ENL requires immunosuppression, which is often required for prolonged periods of time and may lead to serious adverse effects. ENL and its treatment is associated with increased mortality and economic hardship. Improved, evidence-based treatments for ENL are needed; however, defining the severity of ENL and outcome measures for treatment studies is difficult because of the multiple organ systems involved. A cross-sectional study was performed, by the members of the Erythema Nodosum Leprosum International STudy (ENLIST) Group, of patients with ENL attending seven leprosy referral centres in Brazil, Ethiopia, India, Nepal, the Philippines and the United Kingdom. We systematically documented the clinical features and type of ENL, its severity and the drugs used to treat it. Patients with chronic ENL were more likely to be assessed as having severe ENL. Pain, the most frequent symptom, assessed using a semi-quantitative scale was significantly worse in individuals with "severe" ENL. Our findings will determine the items to be included in a severity scale of ENL which we are developing and validating. The study also provides data on the clinical features of ENL, which can be incorporated into a definition of ENL and used for outcome measures in treatment studies.

No MeSH data available.


Related in: MedlinePlus

Duration of ENL and presence of nerve function impairment (NFI).
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pntd.0004065.g007: Duration of ENL and presence of nerve function impairment (NFI).

Mentions: NFI was present in 150 (51.3%) individuals and of those 67 (22.9%) met the criteria for having new NFI. The presence of NFI was significantly associated with the duration of ENL in the 106 individuals who presented with ENL at the time of leprosy diagnosis see Fig 7 (p = 0.035).


ENLIST 1: An International Multi-centre Cross-sectional Study of the Clinical Features of Erythema Nodosum Leprosum.

Walker SL, Balagon M, Darlong J, Doni SN, Hagge DA, Halwai V, John A, Lambert SM, Maghanoy A, Nery JA, Neupane KD, Nicholls PG, Pai VV, Parajuli P, Sales AM, Sarno E, Shah M, Tsegaye D, Lockwood DN, Erythema Nodosum Leprosum International STudy Gro - PLoS Negl Trop Dis (2015)

Duration of ENL and presence of nerve function impairment (NFI).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4564249&req=5

pntd.0004065.g007: Duration of ENL and presence of nerve function impairment (NFI).
Mentions: NFI was present in 150 (51.3%) individuals and of those 67 (22.9%) met the criteria for having new NFI. The presence of NFI was significantly associated with the duration of ENL in the 106 individuals who presented with ENL at the time of leprosy diagnosis see Fig 7 (p = 0.035).

Bottom Line: The treatment of ENL requires immunosuppression, which is often required for prolonged periods of time and may lead to serious adverse effects.ENL and its treatment is associated with increased mortality and economic hardship.The study also provides data on the clinical features of ENL, which can be incorporated into a definition of ENL and used for outcome measures in treatment studies.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom.

ABSTRACT
Erythema nodosum leprosum (ENL) is a severe multisystem immune mediated complication of borderline lepromatous leprosy and lepromatous leprosy. ENL is associated with skin lesions, neuritis, arthritis, dactylitis, eye inflammation, osteitis, orchitis, lymphadenitis and nephritis. The treatment of ENL requires immunosuppression, which is often required for prolonged periods of time and may lead to serious adverse effects. ENL and its treatment is associated with increased mortality and economic hardship. Improved, evidence-based treatments for ENL are needed; however, defining the severity of ENL and outcome measures for treatment studies is difficult because of the multiple organ systems involved. A cross-sectional study was performed, by the members of the Erythema Nodosum Leprosum International STudy (ENLIST) Group, of patients with ENL attending seven leprosy referral centres in Brazil, Ethiopia, India, Nepal, the Philippines and the United Kingdom. We systematically documented the clinical features and type of ENL, its severity and the drugs used to treat it. Patients with chronic ENL were more likely to be assessed as having severe ENL. Pain, the most frequent symptom, assessed using a semi-quantitative scale was significantly worse in individuals with "severe" ENL. Our findings will determine the items to be included in a severity scale of ENL which we are developing and validating. The study also provides data on the clinical features of ENL, which can be incorporated into a definition of ENL and used for outcome measures in treatment studies.

No MeSH data available.


Related in: MedlinePlus