Eye lesions in leprosy - abstract

It has been reported that there has been a high incidence of eye lesions in leprosy. Thirty-seven patients of the Hansen Home, Spanish Town, have been examined clinically, by ophthalmoscope and slit lamp, as part of a preliminary survey. Thirteen cases showed no demonstrable eye lesions and fifteen cases had lesions considered due to leprosy.(AU)

A study of the blood in leprosy: cytology and clotting

Ninety cases of leprosy were examined. All cases except two were under treatment with the sulphones. A hypochromic, normocytic anaemia was present in 80 percent of males and 60 percent of females. This had been reported previously in leprosy and also in patients under treatment with the sulphones. Nine per cent of cases showed a marked basophilia and basophils were present in 26 percent of cases. The relationship is not understood. Twenty-five per cent of cases showed the presence of atypical monocytes, a finding which has previously been observed in leprosy. A contradictory tendency to thrombocytopenia with a shortened bleeding time was found, with normal clotting and prothrombin times. The significance of these findings is not understood. (AU)

Some immunological aspects of leprosy - abstract

Most cases of leprosy belong to two very contrasting types of the disease - the lepromatous and the tuberculoid. The lepromatous type is usually lepromin test negative, whereas the tuberculoid type is generally lepromin test positive. It is generally accepted that lepromin test positive individuals rarely develop leprosy and if they do, the disease is mild and the prognosis relatively good. There is some evidence that tuberculosis or B.C.G. vaccination produces conversion from lepromin negativity to lepromin positivity. This has been explained on the basis of a cross-immunity between leprosy and tuberculosis and has led French and South American workers to advocate B.C.G. vaccination as a means of leprosy control. In view of the above statements the specific problem at present under review is the answer to the following question:- Does the allergic response of the host's tissues determine the type of leprosy or does the type of leprosy determine the allergic response? RESULTS (Preliminary investigations): 1. Tuberculin Test: 53 percent(57/108) were tuberculin positive. In Jamaica generally, tuberculin positivity (all ages) is about 50 percent. 2. Histology of positive tuberculin reactions: Twelve patients were studied (7 lepromatous, 3 tuberculous and 2 indeterminate). (a) All showed acute reaction consisting of oedema, focal haemorrhage and tissue necrosis and also a granulomatous infiltration of mononuclear cells. Five showed marked vesication. (b) Four of the lepromatous type showed a lepromatous reaction (isopathic phenomenon) in that the macrophage cells contained acid-fast bacilli and fat. CONCLUSIONS (Provisional): Clinically (and histologically about 50 percent of the patients were found to be sensitive to tuberculo-protein. If this sensitivity is due to tuberculosis (and the incidence is the same as in the general populace), the result suggests that there is little evidence of cross-immunity between tuberculosis and leprosy. Histologically, 4/7 lepromatous cases biopsied showed an isopathic phenomenon which may indicate that the type of leprosy influences the allergic response (AU)

Microfilariasis in the Turks Islands

The incidental finding of microfilariasis, possibly by Mansonella ozzardi, in two patients receiving treatment for leprosy is described. Both patients live in the same island in the Turks Islands Dependency and this is the first reported incidence of filariasis in this region. In neither patient was there any symptomatology referable to the infestation and the microfilariae were demonstrated during a routine blood examination prior to the institution of sulphone therapy for leprosy. Apart from the demonstration of the organisms and the presence of an eosinophilia, laboratory findings were not remarkable. Both patients responded well to the sulphone therapy and were discharged home to continued ambulatory treatment. No specific treatment for M. ozzardi filariasis has yet been described and, in the absence of untoward symptoms, none was attempted. The field treatment of complete populations by Hetrazan is briefly referred to. (AU)