Abstract
Currently, there are no laboratory tests or sensitive and specific molecular markers for the early diagnosis of leprosy. The aim of this study was to analyze the clinical characteristics of patients with leprosy and investigate their immunological profile, comparing this with the type of lesion and the presence or absence of a Bacillus Calmette-Guérin (BCG) vaccination scar. Statistical analyzes were performed by employing comparative tests (Pearson´s chi-square) to evaluate the variables in different clinical forms, considering significance at the 5% level. The study identified a predominance of lepromatous leprosy (26.9%) in patients aged between 34-53 years. Caucasians predominantly had borderline tuberculoid (BT) clinical forms (42%); a predominance of males with borderline lepromatous (19%) and lepromatous leprosy (26.9%) forms was observed; and the presence of BCG vaccination scars (27.5%) and lower limb nerves were more affected (38%) predominantly in the BT clinical form. Significant differences were identified, which included hypochromic lesions predominantly in the BT clinical form (24%); diffuse-type lesions predominantly in the tuberculoid (TT) clinical form (28%); ill-defined lesion border dominance in lepromatous leprosy (LL) clinical forms (30%); an irregular lesion limit predominantly in LL clinical forms (32%); and a predominant Th1 immune response in the BT clinical form (41.7%). The evaluation of the immunological profile in leprosy patients may contribute to the more detailed diagnosis and possibly better characterization of the prognosis for these individuals.
Highlights
There are no laboratory tests or sensitive and specific molecular markers for the early diagnosis of leprosy
The aim of this study was to analyze the clinical characteristics of patients with leprosy and investigating their immunological profile, comparing this with the type of lesion and the presence or absence of a scar related to Bacillus Calmette-Guérin (BCG) vaccination
Twenty-six patients were Caucasian with a predominance of the the tuberculoid (TT) (n=6; 2%) and borderline tuberculoid (BT) (n=11; 42.3%) clinical forms; 24 were Mulatto, with a predominance of the BL (n=6; 25.0%) and lepromatous leprosy (LL) (n=6; 25.00%) forms; 20 were Black, with a predominance of the BB (n=5; 25.0%) and LL (n=6; 30.0%) forms
Summary
There are no laboratory tests or sensitive and specific molecular markers for the early diagnosis of leprosy. The correct diagnosis of leprosy requires evolutionary clinical data of the disease, histopathological analysis and sputum smear microscopy, enabling determination of the form presented by the patient, such as: TT (tuberculoid), BT (borderline tuberculoid), BB (borderline borderline), BL (borderline lepromatous) and LL (lepromatous leprosy)[3,4,5]. This classification is necessary for the appropriate, specific therapeutic option to be delivered[6,7]. There is a need to intensify leprosy surveillance, with more effective diagnosis and treatment of the disease, with an emphasis on the regions with the highest rates of disease in the country[9]
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