Patient with leprosy awaiting renal transplant in the USA

 Leprosy Mailing List – April 13^th, 2011

Ref:    Patient with leprosy awaiting renal transplant in the USA
From: S., Pasquali, Reggio Emila, Italy

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Dear Dr Noto,

Thank you very much to prof. Coster for presenting her case (LML April 6th, 2011).  Referring to the kidney damage, in my opinion it could be a rare case of leprosy related endo-extracapillary glomerulonephritis, as already described (Clin. Exp. Nephrol. 2010- 14:268) that has evolved to end stage kidney disease.  The pathogenesis is immuno-mediated, the leprosy bacillus being the causing antigen (primum movens) and the host response causing cryoglobulinemia usually found in as many as 95% of cases (Clin. Exp. Dermatol 2002 – 27: 451).

So in my opinion, as long as leprosy disease is well controlled, kidney transplant can be offered to the patient.

Best regards,

Sonia Pasquali
Head, Kidney Unit
Ospedale Santa Maria Nuova
Reggio Emilia
Italy