Leprosy Mailing List – December 10, 2019
Ref.: (LML) ENL and pregnancy
From: Barbara Stryjewska, Baton Rouge, USA
Dear Pieter,
Treatment of young, pregnant women afflicted with HD is one of the most difficult challenges.
Prescribing thalidomide for female patients in child bearing age is severely restricted and allowed only when patient uses two methods of contraception; one semi-permanent; injectable or implantable progesterone, condoms and is verified by monthly pregnancy tests.
I agree with Dr Wim van Brakel, that high dose of Clofazimine 300-200mg daily in divided dose (WHO protocol), taken with the fatty meal (to improve absorption of this lipophilic drug) will be the best treatment option. It should be combined with steroids that will be tapered off but not discontinued.
When patient become more stable, she might be kept on steady, low dose of steroids to avoid fluctuations in ENL outbreaks.
Barbara M. Stryjewska, M.D.
Chief Medical Officer
Principal Investigator
Clofazimine IND # 67,033
National Hansen's Disease Programs/HSB/
1770 Physicians Park Drive
Baton Rouge, LA 70816
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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