Positive Mitsuda lepromin reactions in long-term treated lepromatous leprosy.

Twenty-four lepromatous (LL) patients, treated for 22 to 40 years with chemotherapy, including sulphones and with multidrug therapy, were tested with standard Wade-Mitsuda lepromin. Thirteen gave weak positive (3-4 mm) Mitsuda reactions, confirmed histologically in the ten whose reactions were biopsied. Six of the eleven negative reactors were partly accounted for by a history of relapse, and two others had probably taken dapsone irregularly. Eleven control LL patients, treated for less than 20 years, were uniformly lepromin negative. Spontaneous lepromin conversion appears to occur around 24 years after commencing successful chemotherapy. The late Mitsuda conversions are attributed to delayed clearance of the reservoir of bacterial antigen, but a poor correlation between Mitsuda and Fernandez positivity is not explained.

[1]  D. Ridley,et al.  Tuberculoid relapse in lepromatous leprosy. , 1990, Leprosy Review.

[2]  G. Kaplan,et al.  The reconstitution of cell-mediated immunity in the cutaneous lesions of lepromatous leprosy by recombinant interleukin 2 , 1989, The Journal of experimental medicine.

[3]  H. Takizawa,et al.  [Twenty years observation of lepromin reaction (Mitsuda antigen) in leprosy patients]. , 1986, Nihon Rai Gakkai zasshi.

[4]  M. Waters,et al.  Giant reactions to tuberculin in lepromatous leprosy patients. , 1985, International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association.

[5]  F. Liew,et al.  Failure to induce delayed-type hypersensitivity to Mycobacterium leprae in long-term treated lepromatous leprosy patients. , 1981, Clinical and experimental immunology.

[6]  J. Stanford,et al.  Multiple skin testing of tuberculosis patients with a range of new tuberculins, and a comparison with leprosy and Mycobacterium ulcerans infection , 1977, Journal of Hygiene.

[7]  D. Ridley Histological classification and the immunological spectrum of leprosy. , 1974, Bulletin of the World Health Organization.

[8]  S. Frøland,et al.  Evidence that the Mechanism of Immunological Tolerance (‘Central Failure’) Is Operative in the Lack of Host Resistance in Lepromatous Leprosy , 1972, Scandinavian journal of immunology.

[9]  N. Mukerjee,et al.  The late lepromin reaction in subsided lepromatous cases. , 1961, International journal of Leprosy.