Leprosy Mailing List – November 19th, 2012
Ref.: Type 2 (ENL) reaction in pregnancy
From: P. Saunderson, Greenville, SC, USA
Dear Salvatore,
This is an interesting case [ENL reaction in pregnancy, LML Nov. 14th 2012], but probably not very unusual. It has long been suspected that pregnancy may precipitate reactions. MDT is regarded as safe in pregnancy, so should definitely be started straight away; it is important that iron and folate supplements are given to prevent anaemia.
Regarding the Type 2 reaction, the description given sounds florid enough that prednisolone is required. I have used chloroquine for reactions in the past, but it was not very effective in more severe cases, and high doses were required. The main goal in using prednisolone would be to keep the dose as low as possible to control the disease.
Sincerely,
Paul Saunderson
LML - S Deepak, B Naafs, S Noto, P A M Schreuder
LML Archives: http://www.aifo.it/english/resources/online/lml-archives/index.htm
Dr Salvatore Noto
Padiglione Dermatologia Sociale
Ospedale San Martino
Largo R. Benzi, 10
16132 Genoa, Italy
Tel: (+39) 010 555 27 83 - Fax: (+39) 010 555 66 41 - E-mail: salvatore.noto@hsanmartino.it
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