LEPROSY
Leprosy Review
0305-7518
British Leprosy Relief Association
Colchester, UK
08-5091
0305-7518/13/064053+07
10.47276/lr.84.1.85
Original Papers
Bacterial load in the nose and its correlation to the immune response in leprosy patients
FleuryRaul Negrão
ca
National Reference Center for Sanitary Dermatology and Leprosy, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil
b
Department of Otorhinolaryngology, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil
c
Laboratory of Pathology, Institute Lauro de Souza Lima, Bauru, São Paulo, Brazil
d
Department of Internal Medicine, Faculty of Medicine, Federal University of Uberlandia, Minas Gerais, Brazil
Correspondence to: Isabela Maria Bernardes Goulart, Av. Aspirante Mega, 77 – Bairro Jaraguá Uberlândia, MG, Brazil, 38413-018 (Tel: + 34 3216-7872 or (34) 3238-1530; e-mail: imbgoulart@ufu.br or e-mail: isagoulart@centershop.com.br)
01032013
84
1
85
91
27022013
© Lepra
2013
Introduction:
Leprosy, whose etiologic agent is M. leprae, has its clinical manifestations correlated with distinct immunologic forms. The mechanism of infectivity and dissemination of the disease are not completely known, although the nasal mucosa is supposed to have an important role in pathogenesis.
Objective:
To correlate the clinical and bacteriological parameters with that of nasal biopsy and immunological tests, such as lepromin and ML-Flow results, in untreated leprosy patients.
Material and Method:
Two hundred and twenty-two patients were evaluated, clinically classified and subjected to skin smear, nasal biopsy, ML-Flow, and Mitsuda test.
Results:
68.9% of the cases were borderline cases. Nasal biopsy revealed 91.4% positivity in those who had specific antibodies against M. leprae on blood sample. Lepromatous leprosy cases were 100% positive on ML-flow test, had a large involvement in the nasal mucosa (91%), positive skin smears (100%) and negative Mitsuda test. Nasal bacillary index showed a good correlation with ML-Flow and had similar results when compared to skin smear. The tests agreement was good, revealing that nasal biopsy can be reliable in the diagnosis of multibacillary clinical forms and in the evaluation of the immunological status of leprosy patients.
Conclusion:
The presence of disseminated bacilli in the nasal mucosa was similar to skin involvement, when correlated with Mitsuda test and ML-Flow. As a result, the role of nasal bacillary index may play an important role in the clinical and immunologic characterization of leprosy patients.