Leprosy and Tuberculosis Co-Infection: Clinical and Immunological Report of Two Cases and Review of the Literature.

Trindade MA, Miyamoto D, Benard G, Sakai-Valente NY, Vasconcelos DD, Naafs B.

Source

Hanseniasis Outpatient Unit, Laboratory of Medical Investigation Units 56 and 53, Division of Dermatology, Clinics Hospital, Medical School, University of Sao Paulo, Brazil; Health Institute, São Paulo State Health Department, Brazil; Laboratory of Medical Mycology, Tropical Medicine Institute, University of São Paulo, Brazil; Stichting Tropen Dermatologie Munnekeburen, The Netherlands.

Abstract

A review of the records of patients seen between 2004 and 2011 at the Dermatology Clinic of the São Paulo University Medical School showed that only two leprosy patients had been co-infected with tuberculosis (TB). One patient showed a type 1 leprosy reaction during the first 3 months of treatment of pleural TB and in the other patient, pulmonary TB was diagnosed during the first 3 months of treatment of a type 1 leprosy reaction. Both patients showed normal cellular immune response tests, including those of the interferon-gamma (IFN-γ)/interleukin 12 (IL-12) axis. Although both mycobacterial infections are endemic in developing countries like Brazil, the co-infection has hardly been reported in the last decade. There is no suitable explanation for this observation. The reports on the interaction between the two mycobacteria are highly speculative: some studies suggest that leprosy, especially the anergic form, would predispose to TB, whereas other investigations suggested an antagonism between the two diseases.