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病例报告:类固醇治疗抵抗的复发性 2 型麻风反应伴多发神经功能障碍:治疗挑战

Case Report: Recurrent Type 2 Leprosy Reaction Associated with Multiple Nerve Function Impairments Refractory to Steroids: A Therapeutic Challenge.

机构信息

Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India.

出版信息

Am J Trop Med Hyg. 2024 Jul 23;111(4):844-847. doi: 10.4269/ajtmh.23-0486. Print 2024 Oct 2.

Abstract

Nerve function impairment (NFI) in leprosy results in serious deformities of the face, hands, and feet and contributes significantly to the stigma associated with the disease. Most literature on NFI focuses on either type 1 reaction-associated NFI, or the silent neuropathy, whereas NFI associated with type 2 reaction (T2R) is less well researched. The latter, however, can be more refractory to conventional treatment, not solely owing to its recurrent nature. We present a therapeutically challenging case of a 31-year-old male with borderline lepromatous leprosy with recurrent T2R associated with recurrent and progressive sensorimotor NFI, largely unresponsive to oral steroids and multibacillary, multidrug therapy.

摘要

麻风病导致的神经功能损伤(NFI)会引起面部、手部和脚部的严重畸形,是导致麻风病患者产生耻辱感的重要原因。大多数关于 NFI 的文献主要集中在 1 型反应相关的 NFI 或无症状性神经病,而与 2 型反应(T2R)相关的 NFI 研究较少。然而,后者可能更难治疗,不仅仅是因为它的复发性。我们报告了一例具有挑战性的病例,一名 31 岁男性,边界性瘤型麻风病患者,反复发生 2 型反应,伴有反复和进行性感觉运动性 NFI,对口服类固醇和多菌型多药治疗反应不佳。

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