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首页> 外文期刊>Journal of Clinical and Diagnostic Research >Azathioprine in Chronic Recalcitrant Erythema Nodosum Leprosum:A Case Report FD01-FD02
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Azathioprine in Chronic Recalcitrant Erythema Nodosum Leprosum:A Case Report FD01-FD02

机译：慢性顽固性结节性红斑狼疮中的硫唑嘌呤：FD01-FD02病例报告

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Erythema Nodosum Leprosum (ENL) may have a chronic course which may be recalcitrant to treatment. Preferred treatment modalities are systemic corticosteroids and thalidomide. Azathioprine, methotrexate and cyclosporine are immunosuppressants which may also be used as a steroid sparing agent. We report the case of a 48-year-old male diagnosed as lepromatous leprosy that developed ENL after four months of Multibacillary Multi-Drug Therapy (MB-MDT). He was treated with oral prednisolone (1 mg/kg/day) which was gradually tapered upto a dose of 7.5 mg/day. He developed recurrences on and off once the dose reached the said level and this continued for three years. Oral clofazamine (300 mg/day x 6 months; then 100 mg/day x 6 months) was also added in the second year. Thalidomide (200 mg/day) was also given but withdrawn due to adverse effect after 10 days. Azathioprine was started at a dose of 100 mg/day following which there was resolution of symptoms by one week and no recurrences by 10 weeks; it was given for eight months after which the dose was tapered to 50 mg/day for another four months. Complete withdrawal of oral prednisolone after gradual tapering was possible by 12 months of azathioprine therapy. The patient is still on regular follow-up with no recurrences so far till the last check-up.
机译：红斑结节性麻风病（ENL）可能具有慢性病程，可能使患者难以接受治疗。优选的治疗方式是全身性皮质类固醇和沙利度胺。硫唑嘌呤，甲氨蝶呤和环孢霉素是免疫抑制剂，也可用作类固醇保护剂。我们报告了一例48岁的男性，被诊断为麻风麻风病，经过四个月的多细菌多药治疗（MB-MDT）后发展为ENL。他接受口服泼尼松龙（1毫克/千克/天）治疗，并逐渐逐渐减少至7.5毫克/天。一旦剂量达到上述水平，他就会断断续续地复发，这种情况持续了三年。在第二年还添加了口服氯氟沙明（300 mg /天×6个月;然后100 mg /天×6个月）。也给予沙利度胺（200毫克/天），但由于10天后的不良反应而停用。硫唑嘌呤开始于100毫克/天的剂量，此后1周症状消失，10周后无复发。给予八个月，之后剂量逐渐减少至50 mg / day，持续四个月。逐步减少剂量后，通过硫唑嘌呤治疗12个月可以完全撤出口服泼尼松龙。该患者仍在定期随访中，直到最后一次检查为止均未复发。

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