TYPE 1 LEPROSY REACTION IN A PATIENT WITH LEPROMATOUS LEPROSY: A DIAGNOSTIC AND THERAPEUTIC CHALLENGE

Abstract

This article reports the case of a patient with lepromatous (Virchowian) leprosy who developed a type 1 leprosy reaction during multidrug therapy (MDT) and experienced complications related to the treatment of this condition. Data were obtained through a patient interview and review of the medical records. A 69-year-old woman with lepromatous leprosy confirmed by slit-skin smear presented, in the first months of MDT, with worsening of erythematous, infiltrated, and painful plaques on the upper limbs, associated with sensory neuritis and paresthesia in the hands, and was diagnosed with a type 1 leprosy reaction. During treatment of the infection, hemolytic anemia attributed to dapsone led to a change in the therapeutic regimen, and treatment of the leprosy reaction with prolonged corticosteroid therapy resulted in hyperglycemia and osteoporosis. The infection and the reaction were controlled; however, the patient was left with nerve impairment and joint deformities. This case reinforces that type 1 leprosy reaction can also occur in the lepromatous form, and that its recognition and the monitoring of treatment-related adverse events are essential to reduce the risk of complications.