Renal manifestations of leprosy: glomerulonephritis, a complication of erythema nodosum leprosum

ABSTRACT

Although Mycobacterium leprae does not invade the reanl parenchyma, there are many reports of nephritis in patients leprosy. Glomerulonephritis has been observed in autopsy studies, but the relationship to leprosy has never been clearly estabilished. In the present study, we found urinary abnormalities consistent with glomerulonephritis in 11 of 636 leprosarium inhabitants; there was a strong correlation with a history aof erythema nodosum leprosum (ENL). Seven of 8 noninstitutionalizes patients with active ENL aldo had urinary findings suggestive of glomerunephritis. In 2 patients with ENL, 1 of whom had alterations of serum complement suggestive of complement consumption, renal biopsies revealed proliferative glomerulonephritis. ENL has been considered to reflect, in part, the deposition of circulating immune complexes throught the body. These studies suggest that patients with lepromatous leprosy may expreience glomerulonephritis as one manifestation of ENL, and are consistent with recent observations of immne complex deposition in the glomerular capillary walls of the kidneys of patients with leprosy.