02369nas a2200445   4500000000100000008004100001260001300042653001500055653001000070653000900080653002400089653002000113653001900133653001300152653001100165653001100176653002100187653002500208653002600233653000900259653001600268653001400284653002500298653001500323653002000338653001700358653003200375100001600407700001500423700001300438700001600451700001400467245009600481856004100577300001100618490000700629050001600636520125700652022001401909       1993                            d  c1993 Jun10aAdolescent10aAdult10aAged10aAntigens, Bacterial10aCells, Cultured10aDrug Eruptions10aErythema10aFemale10aHumans10aInterferon-gamma10aLeprosy, lepromatous10aLymphocyte Activation10aMale10aMiddle Aged10aMonocytes10aMycobacterium leprae10aTuberculin10aTuberculin Test10aTuberculosis10aTumor Necrosis Factor-alpha1 aSampaio E P1 aDuppre N C1 aNery J A1 aMoreira A L1 aSarno E N00aDevelopment of giant reaction in response to PPD skin test in lepromatous leprosy patients.  uhttp://ila.ilsl.br/pdfs/v61n2a04.pdf  a205-130 v61  aSAMPAIO19933 a<p>The present study analyzes some clinical and immunological aspects of the giant reaction (GR) in lepromatous leprosy. Sixteen out of a total of 147 (10.9%) lepromatous patients developed the clinical features of GR upon the intradermal administration of PPD; most (14 of 16) GRs occurred in bacteriologically positive cases. GR precipitated an episode of erythema nodosum leprosum (ENL) in three patients. In addition, patients with GR showed enhanced in vitro response to PPD, by the lymphoproliferation test and interferon-gamma assay, as compared to either PPD-negative individuals or PPD-positive patients without GR. Therefore, cell-mediated-immune response to mycobacterial antigens is present in lepromatous patients with GR. It is suggested that the exacerbated in vivo response to PPD in lepromatous leprosy is the result of an increased immunoreactivity to the antigen, which well may be associated with the local and/or systemic release of cytokines [tumor necrosis factor-alpha (TNF alpha) and interferon-gamma (IFN gamma)] by the inflammatory cells. These episodes may, in fact, play an important role in determining the development of disabilities and reactional states, thereby interfering with the prognosis of leprosy disease.</p>
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