An Observational study of Cases of Lepra Reactions by Peripheral Smear and Complete Hemogram

Nisha, K (2020) An Observational study of Cases of Lepra Reactions by Peripheral Smear and Complete Hemogram. Masters thesis, Chengalpattu Medical College and Hospital, Chengalpattu.


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INTRODUCTION: These reactions are the consequences of the immune response to Mycobacterium Leprae (M. leprae) that may occur before, during, or following the completion of multi-drug therapy (MDT). They contribute to the greatest cause of morbidity in lepromatous patients causing nerve damage and deformities. OBJECTIVES: This study is done to analyse the changes in haematological parameters, proportion of cases developing anaemia in lepra reaction, to find out the cell morphology of RBC’S, and to find the proportion of cases with elevated reticulocyte count in an attempt to understand the pathogenesis behind cases of lepra reaction. MATERIALS AND METHODS: A total of 50 cases which includes 42 cases of type I lepra reaction and 8 cases of type II lepra reaction were taken into the study. History regarding the age, sex of the patient, time of occurrence of reaction following MDT were collected. 2ml of blood sample at the time of reaction was collected and analysed using automated cell counters for Hb, RBC count, WBC count, PCV, MCV, MCH, MCHC, DC, RDW and reticulocyte count. Peripheral smear examination was done following Leishman staining of the smears. RESULTS: Neutrophilic leucocytosis was found to be significant. Correlation between the red blood cell indices and haemoglobin levels showed that most of the patients with type I lepra reaction had a normal smear, followed by that of microcytic anaemia whereas the majority of patients with type II lepra reaction had normocytic normochromic anaemia. Most of the reactions in our study occurred after the period of 1 year following MDT, and so anaemia due to dapsone can be ruled out, suggesting that reactions play an important contributory role in development of anaemia in lepra reactions. CONCLUSION: Supplementation of anaemia with iron and folates can reduce the anaemia and the associated co morbidities in lepra reaction.

Item Type: Thesis (Masters)
Additional Information: 201713502
Uncontrolled Keywords: Lepra Reactions, Peripheral Smear, Complete Hemogram, Observational study.
Subjects: MEDICAL > Pathology
Depositing User: Subramani R
Date Deposited: 29 Jan 2021 16:27
Last Modified: 29 Jan 2021 16:27

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