Iqbal M Ahmed.
Present day manifestations of influenza in a Hansen`s disease patient.
J Pak Inst Med Sci Jan ;7(2)8(1,2):550-1.

The advent of antibiotics fluid therapy and other support measures in the last 50 years have decreased the morbidity and mortality of influenza. Possibly, there is also progressive decrease in the virulence of influenza virus. Yet, pulmonary insult and myocarditis can cause severe respiratory failure. S. K. Noordeen and Dharmendra have mentioned adverse effects on the immunity against Hansen`s Disease resulting in epidemics of the disease affecting 25% of the population at large in 1920s. This is not happening now a days.

Case Report: Mr. G.J. was a case of lepromatous disease initially treated elsewhere with dapsone monotherapy from August 1972 to October 1988. He remained well until August 1995, when he relapsed with erythema nodosum leprosum (ENL) manifested by severe hemolysis, lymphadenopathy and nodules scattered all over the body. ESR rose from 40 mm to 131 mm hemoglobin dropped from 13G% to 6.6 G% within 4 weeks and bacillary index was 4.25. In September 1995, he was transferred to this hospital for management of ENL. This time, he was receiving dapsone 100mg OD, Clofazimine 50 mg OD, Aspirin 300 mg TID, Chlorpromazine 25 mg TID, Thalidomide 100 mg QID, Multi-vitamin tablet OD and Rifampin 600 mg, along with Clofazimine 300 mg once monthly. In view of anemia, Dapsone was withdrawn, Clofazimine increased to 200 mg OD and Ferrous sulph. 300 mg, TID, Folic acid, 5 mg TID, Prednisone 30 mg OD and Antacids TID were added. Anemia improved with this treatment and by the end of November 1995, the hemoglobin was normal without the need for blood transfusion. Prednisone was gradually tapered and finally stopped by the beginning of December. Thalidomide was also being reduced before it can finally be stopped. Continued ...

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