Immunochemical determination of transferrin in the blood serum of leprosy patients

Serum transferrin has been studied in 20 normal individuals and 100 leprosy patients, of whom 92 were of the lepromatous type and 8 were tuberculoid. In the 100 cases, 56 had serum transferrin levels within the normal range of the control group. Low concentrations were found in 34 of the 67 lepromatous cases (51%) which were bacteriologically positive, and in 10 cases, 9 lepromatous and 1 tuberculoid, of the 33 (30%) which were bacteriologically negative. The iron-binding capacity as evidenced by the serum transferrin is to establish an equilibrium seems to be altered to a greater extent in the bacteriologically positive lepromatous cases.

C-reative proteins in the sera of patients with leprosy

The C-reactive protein test (CRP) performed by a capillary precipitation method was applied to the sera of 380 leprosy patient, among which 335 were of the lepromatous and 45 of the tuberculoid type. A total of 2,140 tests were performed over a period of two years. The numbers of determinations for each patient ranged between i and 73. Serial CRP tests in 45 tuberculoid cases showed 9 cases (20%) to be consistently positive, 17 cases (37.8%) inconsistently positive, and 19 cases (42.2%) consistently negative. Of the 55 lepromatous cases that were bacteriologically negative ("arrested") at the end of the period, 28 (50.9%) were consistently negative, 17 (30.9%) were inconsistently positive, and 10 (18.1%) were consistently positive. Of the 280 bacteriologically positive lepromatous cases, 96 (34.2%) were consistently negative, 121 (43.2%)inconsistently positive, and 63 (22.5%) consistently positive.

Liver dysfunction in leprosy. Results of the bromsulfalein retention test in 150 cases

Blood specimes from 150 cases of leprosy, 140 lepromatous and 10 tuberculoid, were examined for bromsulfalein retention, thymol turbidity, and cephalin-cholesterol flocculation, and the albumin: globulin ratio and the icterus index were determined. The results of the liver function tests are presented in relation to the bromsulfalein retention. Of the 150 patients, 21 (14%) had an abnormal degree of dye retention; of these cases, 17 were of the lepromatous and 4 of the tuberculoid type. No retention of the dye was noted in 8 of 10 lepromatous cases com´plicated with amyloid nephrosis. A positive icteric index (13.3%) in 15 lepromatous cases, without jaundice and showing no bromsulfalein retention, may indicate that liver damage is more common than can be measured by the BSP test. Explanation of the positive BSP test in leprosy in terms of liver damage from military lepromata must be considered.

Electrolyte studies in leprosy

The alkali reserve and serum electrolytes have been studied in 18 normal individuals and 143 leprosy patients, of whom 24 lepromatous cases had the erythema nodosum leprosum type reaction and 4 were complicated with amyloid nephrosis. In the 115 cases of uncomplicated leprosy, 100 lepromatous and 15 tuberculoid, 76, or 66.1 per cent had abnormal values in one or more of the tests; 39, or 33.9 per cent were within the normal range in all tests performed. REversal of the albumin-globulin ratio was found in 33 of the 85 active (i.e., bacteriologically positive) uncomplicated lepromatous cases. Thhe carbon dioxide combining power was below the minimum normal value of 25 mEq/L in 20 of the lepromatous cases, and sodium was slightly decreased in 27 of them. Serum chlorides were slightly below normal in 17. The average results obtained in the 24 lepromatous cases with erythema nodosum leprosum resemble those of uncomplicated lepromatous leprosy, although there was no constant correlation. Variations in one or more of the tests existed in 19 cases, while 5 showed values within the normal range in all of the tests performed. Of the 4 cases with amyloid nephrosis, none showed normal values in all tests. No definite relationship existed bone changes and the total serum calcium and phosphorus.

Hemoglobin types in leprosy

Paper electrophoresis studies were made to ascertain the frequency of abnormal hemoglobin types among 205 patients (187 lepromatous and 18 tuberculoid) hospitalized at the Public Health Service Hospital, Carville, LOuisiana. As controls, blood was obtained from 21 nonpatients with normal hemoglobin patterns and 3 nonpatients having abnormal patterns. Hemoglobin A, the normal pattern, was found in 163 (79,5%) of the patients. Atypical patterns were observed in 28 of the patients by the method we used. Hemolysates from 12 of the 28 patients were submitted to Chernoff who, using a different method than we had used, identifies 5 of the 12 patterns as follows: hemoglobin C trait, 2; sickle-cell trait, 1; sickle-cell trait with a fast-moving component (unidentified), 1; hemoglobin A plus a fast-moving component (unidentified), 1. Hemoglobin C patterns were noted in 13 instances and hemoglobin C trait pattern in 1 instance. Sickling of the erythrocytes or target cells could not be demonstrated in the group showing atypical patterns, or in those patients exhibiting a hemoglobin C pattern. Fetal hemoglobin F as measured by an alkaline denaturation method showed values within the normal range of less than 1 per cent.

Protein-bound iodine of the blood serum in leprosy

Serum protein-bound iodine determinations were performed on sera from 120 patients with leprosy, of whom 96 had the lepromatous and 24 the tuberculoid type of the disease. As controls, l4 nonpatients were similarly examined. Of the 120 patients, 98 or 81.7 per cent, showed protein-bound iodine levels within the normal range. Elevated levels were found in 6 lepromatous patients and in 1 tuberculoid patient. LOw levels were found in 11 lepromatous and in 4 tuberculoid patients. Abnormal values were found in 14 of the 91 patients on sulfone therapy, 7 having elevated PBI levels and 7 low levels.

Magnesium metabolism in leprosy

Serum magnesium determinations were performed in 177 cases of leprosy, of which 156 were of the lepromatous and 21 of the tuberculoid type. As controls, 27 nonpatients were similarly examined. Of the 177 cases, 132 (75.2%) showed magnesium levels within the normal range. Significantly low concentrations were found in 27 llepromatous cases and 1 tuberculoid case which were bacteriologically positive. Of the 28 cases with low levels, 8 had a clinical diagnosis of amyloid nephrosis and one had diabetes. Slightly elevated levels were seen in 16 lepromatous cases and 1 tuberculoid case. Of this latter group, 6 had a clinical diagnosis of amyloid nephrosis. Leprosy per se does not appear to affect magnesium metabolism. In the series studied, bacteriologically-positive lepromatous cases complicated with amyloid nephrosis tended to show abnormal elevation or depletion of serum magnesium; in 3 of the 14 cases with the tuberculoid condition zero levels were recorded.

A clinico-serologic study of leprosy. I- Results of serologic tests for syphilis, including the treponema pallidum immobilization test

The results obtained in a clinico-serologic study of leprosy patients in the U. S. Public Health Service leprosarium at

An evaluation of the Maillard-Gagliardo complement fixation test in leprosy

1- The Maillard-Gagliardo complement fixation test was performed on sera obtained from 100 cases of leprosy in which a diagnosis of tuberculosis had been excluded. 2- Normal controls showed titers up to 10. 3- Titers above normal were found in 44 (44 per cent) of the 100 cases of leprosy. 4- Titers above normal were found in 33 (58.9 per cent) of the 56 bacteriologically positive cases of lepromatous leprosy. 5- The following comparison is made: (a) modified Middlebrook-Dubos hemaglutination test: 88.5 per cent of the leprosy cases tested showed titers above normal; (b) Maillard-Gagliardo complement fixation test: 44 per cent of the leprosy cases tested showed titers above normal.

Studies on serum proteins in leprosy the alpha, beta and gamma globulin fractions

Serum specimens from 234 cases of leprosy, representing the various types and stages of activity of the disease, were examined for the total serum protein, albumin, total globulin, alpha, beta and gamma globulin fractions. Specimens from 29 employees used as controls were similarly examined. The findings in the patients with respect to the globulin fractions are correlated with the results of the thymol turbidity and cephalin-cholesterol flocculation tests. Of the 234 cases, 118, or 50.4 per cent, showed an increased in one or more of the serum globulin fractions; 27 showed and increase in the alpha globulin, 28 in the beta globulin, 63 in the gamma globulin fraction...

Blood and urine concentrations of free and hydrolyzed sulfones in leprosy patienmts under treatment

A total of 275 determinations of the concentrations of free and hydrolized sulfones in the blood and urine were made in 137 patients over a period of three months. Analyses were made 24 hours after the last dose, and after a rest period of 14 days. In all of the 43 patients under promin treatment, the drug existed in the blood in the free form only, while in the urine it was found in both the free annnd conjugated forms after the 14-day rest period. The ratio between the free and conjugated drug in the urine varied considerably in different individuals. Of the 55 patients taking diasone, 26, or 47.3 per cent, showed conjugation of the drug in the blood 24 hours after the last dose, while in 29, or 52.7 per cent, there was no conjugation in the blood. No form of the drug was present in the blood of any of the patients after a rest period of 14 days. Conjugation in the urine occurred in 52 of the cases, 24 hour after the last oral dose and after the rest period. Concentrations of free and conjugated sulphetrone were noted in the blood and urine in the 15 cases studied, 24 hours after the last dose. This drug was not present in the blood after the rest period. Conjugation of sulphetrone in the urine occurred in 8 of the cases after the rest period, while free sulphetrone was eliminated in all of the cases. When the bloods and urines of 24 patients receiving promacetin were analyzed by directdiazotization and by acid hydrolysis the values for free and total sulfone were identical, which indicates that this drug was unaltered in the body of the patients studied.

Serial cephalin flocculation test in leprosy: a preliminary report

Blood specimens from 425 cases of leprosy (398 of the lepromatous type and 27 tuberculoid) were examined for the cephalin cholesterol flocculation reaction using a serial serum dilution method. Blood specimens from 30 employees were similarly examined as controls. Serial repetitions of this test were performed at weekly intervals over a period of one month on 133 of the 425 cases. Four patterns of floculation are reported. Pattern 1 is presented by apparently normal individuals and was observed in the 30 controls, and also in 57 of the 425 leprosy cases examined. Of these 57 cases, 50 were bacteriologically negative for M. leprae. Pattern 2 was noted in 173 cases, and Pattern 3 in 122, the greatest number occurring in the moderately and far advanced lepromatous cases. These patterns are suggestive of liver dysfunction, since in both patterns the first tube is positive according to the one-tube Hanger method. Pattern 4, which closely approaches the normal pattern, was observed in 73 cases. The serial cephalin flocculation patterns are not found to vary in leprosy when examinations are made at weekly intervals for a period of one month. It is pointed out that many conditions other than liver disease might occasion a change in the pattern of serum proteins, and that this in turn may be reflected in the serum serial dilution cephalin-cholesterol flocculation. The repeated use of this test several times a year may be useful as a guide to therapy and prognosis in the treatment of leprosy, or of concomitant hepatic dysfunction.

Serum phosphatase in leprosy

Sera from 102 lepers, representing various types, stages and degrees of activity of the disease, were examined for inorganic phosphorus and the phosphatase activity. The plasma ascorbic acid was determined in paralled with the phosphatase activity in 70 of the cases. Sera and plasma from 15 normal men and women were similarly examined as controls. The serum phosphatase, calculated on the bases of Bodansky units, averaged within the normal range. Of the 102 leprosy cases, 89 showed normal values, three were slightly above normal, and ten had values below the normal range. There was no definite correlation between the ascorbic acid in the plasma and the phosphatase activity, though the concentration of ascorbic acid was below normal in 46 instances.

Basal metabolism in leprosy

The basal metabolic rate was determined on three hundred and eighteen lepers, representing the various types and stages of progression of the disease and various nationalities. Not included were cases with fever, leprous infiltration of the larynx, or massive infection of the mucous membrane of the mouth and nasal cavities. The erythrocyte count, leucocyte count and hemoglobin estimation was made on two hundred and fifty of the cases. As controls, the basal metabolic rates of thirty apparently normal individuals living under the same climatic conditions were determined. Of three hundred and eighteen cases, two hundred and forty, or 75.4 percent, had rates within the normal limits. there was no definite correlation between the rates and the various stages of progression of the disease.

Blood glutathione in leprosy

Bloods from 96 lepers, between the ages of 20 and 50 years, representing various types and stages of progression and activity of the disease, were examined for total, reduced and ocidized glutathione. Bloods from 15 normal men and women between the ages of 25 and 50 years were similarly examined, as controls. The reduced glutathione showed no appreciable deviations either in regard to the range of variations or in the average values. No correlation can be traced between the amount of this form of glutathione and the stages of progression or of activity of the disease. Definite increase in the oxidized glutathione was found in 23 of the cases, chiefly in the retrogarding group of cases and in the those that were moderately and far advanced. It is known (4) that factors are present in the tissues which promptly reduce the oxidized glutathione whenever its concentration is raised above an equilibrium value. Since the increase of oxidized glutathione was most marked among the patients in whom the disease had progressed for a longer time, there would seem to be a tendency towards excessive tissue destruction which may result in an unbalanced tissue equilibrium with a loss of the oxidized glutathione from the tissues.

Pyretotherapy in leprosy: biochemical changes resulting from exposure to an air-conditioned hypertherm

A study of the physiological and biochemical changes resulting from the production of artificial fever in an air-conditioned hypertherm was mede on five lepers with different grades of involvement by the disease. For comparison, similar studies were made on three nonleprous cases of gonorrhoea and two of syphilis. Marked changes in the acid-base equilibrium were noted, resulting in an uncompensated CO2 deficit, one case developing a moderate alkalotic tetany. There was diminution of serum calcium, not noted in nonlepers, with suggestions that the loss may represent an altered distribution in the tissues of the body due to changes in the acid-base equilibrium, though a possible factor may be the deposition of greater amounts of calcium in the bones. The increase of inorganic phosphorus did not parallel the decrease of serum calcium. There was a marked reduction of the total proteins, which were unusually high before the febrile treatment s were started. Both the serum albumin and serum globulin were decreasedequally, the ratio averaging 1:09 in all of the cases during the entire course of treatment. In nonlepers the total proteins, albumin, and globulin fluctuated within the approximate normal range. There was a definite retention of the nonprotein nitrogen, urea nitrogen, blood chlorides, and cholesterol, accompanied by albuminuria, hyaline and granular casts. In the nonlepers albuminuria and casts accurred after the febrile periods, but no retention of the blood constituents mentioned. It is suggested that there was impairment of the renal function, with partial suppression of the excretory action of the skin during the course of febrile therapy. Phenolsulphophthalein renal function tests failed to show evidence of damage to the kidneys as a result of the treatments...