Guditi S, Ram R, Ismal K M, Sahay M, Dakshinamurthy K V, Girish N, Prasad N
Department of Nephrology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India.
Transpl Infect Dis. 2009 Dec;11(6):557-62. doi: 10.1111/j.1399-3062.2009.00428.x. Epub 2009 Jul 28.
A 52-year-old male underwent living-related renal transplantation. He received prednisolone, azathioprine, and cyclosporine as immunosuppression protocol. Eleven years after transplantation, he developed pyrexia with multiple nodular lesions on his limbs, trunk, and face. Skin biopsy and smears showed the presence of numerous acid-fast bacilli with 5% sulfuric acid indicative of Mycobacterium leprae. He was initiated on multidrug therapy (MDT) including dapsone, clofazimine, and rifampicin. After 2 years of MDT, he developed new multiple erythematous, tender subcutaneous nodules in crops over his face and upper limbs. Skin biopsies and histopathological examination confirmed the diagnosis of type 2 lepra reaction or erythema nodosa leprosum. He was managed with an increase in the dose of prednisolone and thalidomide. He was continued on MDT.
一名52岁男性接受了亲属活体肾移植。他接受泼尼松龙、硫唑嘌呤和环孢素作为免疫抑制方案。移植11年后，他出现发热，四肢、躯干和面部有多个结节性病变。皮肤活检和涂片显示存在大量耐5%硫酸的抗酸杆菌，提示为麻风杆菌。他开始接受包括氨苯砜、氯法齐明和利福平在内的多药联合治疗（MDT）。MDT治疗2年后，他面部和上肢又出现了新的多发、红斑性、压痛性皮下结节。皮肤活检和组织病理学检查确诊为2型麻风反应或结节性红斑麻风。他通过增加泼尼松龙和沙利度胺的剂量进行治疗。他继续接受MDT治疗。
