Leprosy Mailing List – June 1, 2015
Ref.: (LML) Alternative MDT drugs and treatment duration
From: Wim Theuvenet, Apeldoorn, the Netherlands
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Dear Pieter,
I am sorry to hear about Grace ankle!! Hope that she will be jumping again soon!
Thanks for sharing with us the „Indonesian-Australian” patient!!
From the description I conclude that his BI has dropped from 5+ to 2-3+ in 2 years’ time; this looks as the adequate response to 24/12 MDT one can hope for? Personally, in BL/LL cases a drop of 1 point on the BI scale was the average reduction per annum that I have seen.
Unless there are signs of an early relapse/ viable bacilli, is there really a need to reconsider and continue the MDT??
As has been outlined before he may suffer from late (esp. type II) reactions due to the gradual release of fragments of bacilli from the macrophages for several years to come.
The real challenge may lay in the early detection and prevention of late nerve damage which may continue many years after completing the MDT.
Wishing Grace a quick recovery and with my best personal regard to her,
Wim Theuvenet
Plastic, Reconstructive and Hand Surgeon
Consultant for TLMI
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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