ABSTRACT
Type II reaction in leprosy, or erythema nodosum leprosum (ENL), is often characterized by severe clinical symptoms together with nerve function impairment leading to permanent disabilities. Thalidomide has been shown to be a highly effective drug for the treatment of ENL. It is, however, contraindicated for women of childbearing age due to its teratogenicity. On the other hand, pentoxifylline, used to treat hypercoagulable states, is not teratogenic and, like thalidomide, can inhibit the synthesis of tumor necrosis factor-a and other cytokines. In the present randomized double-blind clinical study we compared the effectiveness of orally administered pentoxifylline vs thalidomide in treating type II reaction in 44 patients. Daily doses of 300 mg thalidomide or 1.2 g pentoxifylline were administered for 30 days to multibacillary leprosy patients undergoing type II reaction. Randomly chosen patients were included in the study before, during, and after specific multidrug therapy. Clinical evaluations were performed on the 1st, 7th, 14th, 21st, and 30th days of treatment and laboratory tests were carried out on the 1st and 30th days. As expected, overall, thalidomide proved to be more effective in the treatment of type II leprosy reaction. Nevertheless, continuous treatment with pentoxifylline was effective in relieving the clinical signs of ENL, especially limb edema and systemic symptoms, in 62.5 percent of the patients.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Erythema Nodosum/drug therapy , Leprostatic Agents/therapeutic use , Leprosy, Lepromatous/drug therapy , Pentoxifylline/therapeutic use , Thalidomide/therapeutic use , Double-Blind Method , Leprostatic Agents/adverse effects , Pentoxifylline/adverse effects , Treatment Outcome , Thalidomide/adverse effectsSubject(s)
Middle Aged , Humans , Male , Cytomegalovirus Infections , Heart Diseases , CytomegalovirusSubject(s)
Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Humans , Male , Endocarditis, BacterialSubject(s)
Child, Preschool , Humans , Male , Endocarditis, Bacterial , Neurologic Manifestations , Staphylococcal Infections , StaphylococcusSubject(s)
Child , Humans , Female , Brain Abscess , Endocarditis, Bacterial , Staphylococcal Infections , Vasculitis , Staphylococcus aureusABSTRACT
Analisou-se o conteudo celular dialitica drenada da cavidade peritoneal, durante dialise peritoneal, em cinco pacientes com insuficiencia renal cronica. As celulas obtidas mostraram sempre viabilidade maior que 90%, e foram analisadas pelo metodo de Giemsa e metodos citoquimicos para esterase acida e mieloperoxidase. No inicio do procedimento dialitico, observou-se um pico celular composto basicamente por fagocitos mononucleares, linfocitos e eosinofilos. Em tres dos cincos pacientes, apos grande reducao do numero de celulas drenadas da cavidade peritoneal, observou-se um segundo pico celular composto principalmente por neutrofilos, com desaparecimento de outros tipos celulares. Este segundo pico celular nao foi observado em outros dois pacientes, o que sugere a existencia de diferentes padroes de migracao leucocitaria para cavidade peritoneal