Fw: Ref.: (LML) Visible deformity after HD (leprosy) chemoprophylaxis among India tribals

 

Leprosy Mailing List –  July 19,  2024

 

Ref.:  (LML)  Visible deformity after HD (leprosy) chemoprophylaxis among India tribals

From:  Ben Naafs, Munnekeburen, the Netherlands

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Dear Editor,

 

I think I didn't make it clear in my criticism of Joel Almeida's previous email that I am not at all in favour of SDR or even 2 days of Rifampicin. My criticism was mainly that he used a not so good Brazilian article to support his opinion. As for the Indian data, they are better. 

 

I think it is indeed possible that more disability can occur in a period of 2 years after SDR-PEP. But even better is to compare it after 5-10 years. 

 

The possible cause is that if the patient is not given medication, the adaptive immune system can gradually upgrade to cured or downgrade to lepromatous. After giving medication, the patient suddenly is exposed to additional and different antigenic determinants, this upgrade response can be further enhanced by an enhanced immune system by the BCG. This leads to a T1R that needs to be diagnosed and treated. Otherwise you will indeed get damage.

 

I hope I make it clear what I meant.

 

regards

 

Ben

 

Note editor: we want to stress again that LML is an open forum. Please react, especially when some conclusions could be considered by some quite premature

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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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