• Bmc Infect Dis · Jan 2005

    Case Reports

    Leprosy & gangrene: a rare association; role of anti phospholipid antibodies.

    • Shashank M Akerkar and Lata S Bichile.
    • Dept of Medicine, Seth GSMC & KEM Hospital, Parel, Mumbai, 400012, India. shashank77_2000@yahoo.com
    • Bmc Infect Dis. 2005 Jan 1;5:74.

    BackgroundLeprosy still remains an important public health problem for many parts of the world. An association of gangrene with leprosy is a rare one & can have a number of causative mechanisms. We present a case with Leprosy & gangrene with positive anti phopholipid antibody titers.Case PresentationA 50-year-old non-diabetic, non-hypertensive lady presented with 2 months history of progressive gangrene of bilateral toes. She was found to have madarosis & hypopigmented, hypoaesthetic macular lesions on the upper limb & thighs. Bilateral ulnar & popliteal nerves were thickened. A skin biopsy of the lesions revealed borderline tuberculoid leprosy, slit skin smears revealed a bacteriological index of 1+. She did not have any evidence of thromboembolic episode or atherosclerosis. ACLA was positive at presentation & also on another occasion 6 weeks later. ACLAs were of the IgM type on both occasions. Lupus Anticoagulant & beta2 GPI antibody were negative. DOPPLER of the lower limb arteries did not reveal any abnormality. Patient was successfully treated with multi-drug antileprotics & anticoagulants.ConclusionInfectious APLAs should be recognized as a cause of thrombosis in Leprosy. Appropriate anticoagulation can salvage limb function.

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