Leprosy Mailing List – December 18, 2013
Ref.: (LML) Thalidomide in treating kidney involvement in ENL
From: Ben Naafs, Munnekesburen, the Netherlands
Dear Pieter,
I would like to thank Dr. Jingquan Wang for his interesting question about the use of Thalidomide in treating kidney involvement in ENL (LML, December 16, 2013). ENL is a stressful situation, the patient is really severely ill; proteinuria, albuminuria, is a frequent symptom is this condition. Treatment of the ENL reverses this situation, the patient becomes better and the proteinuria disappears. This is independent of the way the ENL is being treated and happens with spontaneous evolution too. When proteinuria remains, permanent damage may have happened or there is still another stressful condition.
When after the proteinuria disappears, blood and leukocytosis remains, I think for example of an urinary tract infection, particular in women. This could also has been the triggering factor for the ENL.
ENL in all other organs can be treated with thalidomide too. Sometimes, however, in case of neuritis or iritis steroids may be advisable. Thalidomide is widely used in Brazil and they should have a lot of experience with internal organs involvement in ENL and how to treat.
With kind regards,
Dr Ben Naafs
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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