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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >A Patient with Erythema Nodosus Leprosum and Chagas Cardiopathy: Challenges in Patient Management and Review of the Literature.
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A Patient with Erythema Nodosus Leprosum and Chagas Cardiopathy: Challenges in Patient Management and Review of the Literature.

机译：红斑结节性麻风病和恰加斯州心脏病患者：患者管理和文献复习中的挑战。

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Abstract. We report a patient with severe multi-bacillary leprosy complicated by recurrent episodes of erythema nodosum necrotisans that required thalidomide and/or corticosteroids during follow-up. Although the patient was from an area to which Chagas disease is endemic, this diagnosis was initially missed and was only investigated when heart failure developed in the patient. The difficulties of managing erythema nodosum necrotisans and heart failure concomitantly and those involved in excluding the diagnosis of acute myocarditis caused by reactivation of Chagas disease secondary to the immunosuppressive regimen are discussed. Other potential causes for the heart failure and possible interactions between the two diseases and their treatments are discussed. We also reviewed the literature for the association between leprosy and Chagas disease, both of which are highly endemic in Brazil. This case emphasizes the importance of searching for subclinical co-infections in leprosy patients because reactions frequently develop during specific treatment in these patients, and these reactions require prolonged therapy with immunosuppressive drugs.
机译：抽象。我们报告一名患者患有严重的多细菌性麻风病，并伴有反复发作的结节性红斑坏死病，在随访期间需要沙利度胺和/或皮质类固醇。尽管患者来自恰加斯病流行的地区，但最初并未漏诊此诊断，只有在患者出现心力衰竭时才进行诊断。讨论了同时治疗结节性红斑坏死和心力衰竭的困难，以及排除免疫抑制方案后继查加斯病再激活引起的急性心肌炎诊断的障碍。讨论了导致心力衰竭的其他潜在原因以及两种疾病之间的可能相互作用及其治疗方法。我们还回顾了麻风病和恰加斯病之间的关联文献，两者在巴西都是地方性流行病。这种情况强调了在麻风病患者中寻找亚临床共感染的重要性，因为在这些患者的特定治疗期间反应经常发生，并且这些反应需要长期使用免疫抑制药物进行治疗。

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