Patnaik J K, Saha P K, Satpathy S K, Das B S, Bose T K
Medical & Health Services, Ispat General Hospital, Orissa, India.
Int J Lepr Other Mycobact Dis. 1989 Jun;57(2):499-505.
Liver function tests and liver biopsies were studied in 23 leprosy patients in reaction and 10 without reaction. The liver biopsies in leprosy patients with reaction showed exudative lesions, epithelioid and tuberculoid granulomas, and foam-cell granulomas. Portal vasculitis was encountered in a few cases. Neutrophilic infiltration into the foam-cell granulomas was seen in a few cases of lepromatous (LL) leprosy with reaction. In six cases of borderline (BL, BB and BT) leprosy with reaction, a spectrum of lesions bearing footprints of exudative lesions were seen evolving into epithelioid-cell granulomas. Foam-cell granulomas and tuberculoid and epithelioid granulomas along with exudative lesions were encountered in two cases on individual biopsy strips. An altered albumin-to-globulin ratio was the chief functional derangement observed in these cases. The spectrum of changes observed in borderline leprosy with reaction could be discrete steps in the evolution of upgrading reaction.
对23例处于反应期的麻风患者和10例无反应的麻风患者进行了肝功能检查和肝活检。处于反应期的麻风患者的肝活检显示有渗出性病变、上皮样和结核样肉芽肿以及泡沫细胞肉芽肿。少数病例出现门静脉血管炎。在少数有反应的瘤型（LL）麻风病例中，可见中性粒细胞浸润到泡沫细胞肉芽肿中。在6例有反应的界线类（BL、BB和BT）麻风病例中，可见一系列带有渗出性病变痕迹的病变演变为上皮样细胞肉芽肿。在个别活检条上的2例中，发现了泡沫细胞肉芽肿、结核样和上皮样肉芽肿以及渗出性病变。观察到的主要功能紊乱是白蛋白与球蛋白比值改变。在有反应的界线类麻风中观察到的一系列变化可能是升级反应演变过程中的离散步骤。
