■麻风反应代表免疫介导的急性炎症发作,如果没有及时诊断和治疗,会导致不可逆的神经功能损伤和永久性残疾。麻发病麻风病(LL)和临界麻发病麻风病(BL)患者经历的常见反应类型是结节性麻风病红斑(ENL),炎症并发症,可能成为慢性或多次复发。尽管ENL通常被描述为中性粒细胞介导的免疫疾病,中性粒细胞的作用尚不完全清楚.在这项研究中,我们在BL或LL麻风病患者的回顾性队列中评估中性粒细胞增多.
■使用在SouzaAraújo门诊诊断和治疗的146例BL和LL麻风病患者的数据进行了回顾性观察研究,Fiocruz,里约热内卢,巴西。临床,人口统计学,和血液学数据从医疗记录中提取。从用于ENL诊断的患者获得的皮肤活检样品用于组织病理学评估。
■大多数患者是男性(75%),并且有反应性发作(85%),其中65%是ENL。多次发作很常见,80例ENL患者中55%出现2次以上发作(平均2.6次)。在未接受治疗的BL/LL患者中,在病程的某些时间点发生ENL的患者的中性粒细胞计数中位数高于未发生任何反应的患者(中位数分别为4,567个细胞/mm3和3,731个细胞/mm3,p=0.0286)。证实了中性粒细胞计数中位数增加与ENL严重程度之间的相关性(轻度ENL为6,066细胞/mm3,中度/重度ENL为10,243细胞/mm3,p=0.0009)。还对34例患者进行了纵向评估,证实嗜中性白细胞增多(BL/LL:4896细胞/mm3vsENL:8408细胞/mm3,p<0.0001)。此外,NLR增加与ENL病变中嗜中性粒细胞浸润增加相关.
■我们证明,麻风病患者的ENL发作与血液白细胞和中性粒细胞计数升高以及NLR升高有关。这些发现强调了中性粒细胞在ENL免疫/炎症过程中的显著参与。
UNASSIGNED: Leprosy reactions represent immunologically mediated episodes of acute inflammation that, if not diagnosed and treated promptly, can cause irreversible impairment of nerve function and permanent disabilities. A frequent type of reaction experienced by patients with lepromatous leprosy (LL) and borderline lepromatous leprosy (BL) is erythema nodosum leprosum (ENL), an inflammatory complication that may become chronic or recur in multiple episodes. Although ENL is commonly described as a neutrophil-mediated immune disease, the role of neutrophils is not fully understood. In this study, we assess neutrophilic leukocytosis in a retrospective cohort of patients affected by BL or LL leprosy.
UNASSIGNED: A retrospective observational study was performed using data from 146 patients with BL and LL leprosy diagnosed and treated at the Souza Araújo Outpatient Clinic, Fiocruz, Rio de Janeiro, Brazil. Clinical, demographic, and hematological data were extracted from medical records. Skin biopsy samples obtained from patients for ENL diagnosis were used for histopathological evaluations.
UNASSIGNED: Most patients were male (75%) and had a reactional episode (85%), of which 65% were ENL. Multiple episodes were common, 55% of the 80 patients with ENL presented more than 2 episodes (average of 2.6 episodes). In treatment-naive BL/LL patients, the median blood neutrophil counts of patients who developed ENL at some points of their disease course were higher than those who did not experience any reaction (median= 4,567 cells/mm3 vs 3,731 cells/mm3 respectively, p=0.0286). A correlation between the increase in median neutrophil counts and ENL severity was confirmed (6,066 cells/mm3 for mild ENL vs 10,243 cells/mm3 for moderate/severe ENL, p=0.0009). A longitudinal assessment was also performed in 34 patients, confirming the neutrophilic leukocytosis (BL/LL: 4896 cells/mm3 vs ENL: 8408 cells/mm3, p<0.0001). Moreover, increased NLR was associated with a greater neutrophilic infiltration in ENL lesions.
UNASSIGNED: We demonstrate that ENL episodes in patients affected by leprosy are associated with elevated blood leukocyte and neutrophil counts and an increased NLR. These findings highlight the significant involvement of neutrophils in the ENL immunological/inflammatory process.