TY - JOUR
KW - COVID-19
KW - Erythema nodosum leprosum
KW - Immunosuppressants
KW - Interferon-gamma
KW - leprosy
KW - Methotrexate
KW - Type 2 Lepra reaction
KW - case report
KW - Corticosteroids
AU - Saxena S
AU - Khurana A
AU - B S
AU - Sardana K
AU - Agarwal A
AU - Muddebihal A
AU - Raina A
AU - Paliwal P
AB - <p>Type 2 leprosy reaction(T2LR) or Erythema Nodosum Leprosum (ENL) often poses a therapeutic challenge to clinicians and commonly requires long courses of steroids for control. While immunosuppressants are inculcated to achieve control and lower the steroid dependence in T2LR, the prospect of managing a severe T2LR in conjunction with COVID-19 with the concern of worsening COVID-19 with the long term immunosuppression, as well as T2LR with the concomitant infection has not been previously encountered. We report a case of severe T2LR on oral steroids and methotrexate, who acquired COVID-19 infection during hospital stay and had a favourable outcome despite continued use of the immunosuppressives. Further, we discuss the possible reasons for this, both in terms of the drug pharmacodynamics and the immunological profile of T2LR.</p>
BT - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
C1 - https://www.ncbi.nlm.nih.gov/pubmed/33326870
DA - 12/2020
DO - 10.1016/j.ijid.2020.12.024
J2 - Int J Infect Dis
LA - eng
N2 - <p>Type 2 leprosy reaction(T2LR) or Erythema Nodosum Leprosum (ENL) often poses a therapeutic challenge to clinicians and commonly requires long courses of steroids for control. While immunosuppressants are inculcated to achieve control and lower the steroid dependence in T2LR, the prospect of managing a severe T2LR in conjunction with COVID-19 with the concern of worsening COVID-19 with the long term immunosuppression, as well as T2LR with the concomitant infection has not been previously encountered. We report a case of severe T2LR on oral steroids and methotrexate, who acquired COVID-19 infection during hospital stay and had a favourable outcome despite continued use of the immunosuppressives. Further, we discuss the possible reasons for this, both in terms of the drug pharmacodynamics and the immunological profile of T2LR.</p>
PY - 2020
T2 - International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases
TI - Severe Type 2 leprosy reaction with COVID-19 with a favourable outcome despite continued use of corticosteroids and methotrexate and a hypothesis on the possible immunological consequences.
UR - https://www.ijidonline.com/article/S1201-9712(20)32547-9/pdf
SN - 1878-3511
ER -