Leprosy Mailing List – June 1, 2015
Ref.: (LML) Alternative MDT drugs and treatment duration
From: Indropo Agusni, Surabaya, Indonesia
Dear Pieter,
Following the discussion about Dr. Warren's leprosy patients, since the patient came from Indonesia and got allergy to Dapsone, I'd like to know from which part of Indonesia? If the patient is originally from Papua, we have many reports on Dapsone Syndrome from this area. But if he is not from Papua, then it might be just an individual allergy.
I think the important first target to reach is to make the patient become non-infectious. It is not clear how is the initial Morphological Index (M.I.). If the MI became 0% after treatment, that means the bacilli is sensitive to the anti-leprosy drug which is given. The following target is to eliminate all the fragments of bacilli. For this purpose we need to improve the CMI (Cellular Mediated Immunity) of the patient, since the cleaning of bacilli' fragment is the duty of this system. If there is available, it is worth to perform a serologic test for leprosy (IgM and IgG anti PGL-1 antibody). By monitoring the serological titres, especially the IgM antibody, we could assess the activity of the disease. Hopefully this comment will be useful.
Indropo Agusni.
Prof. of Dermatology , Surabaya – Indonesia
LML - S Deepak, B Naafs, S Noto and P Schreuder
LML blog link: http://leprosymailinglist.blogspot.it/
Contact: Dr Pieter Schreuder << editorlml@gmail.com
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