Dados do Trabalho

Título

Neutrophilic Leukocytosis and Elevated NLR in Erythema Nodosum Leprosum: A Retrospective Study of Leprosy Patients

Introdução

Erythema Nodosum Leprosum (ENL) is an immunological complication of leprosy that leads to inflammatory skin nodules which may result in nerve and organ damage, and may occur years after antibiotic treatment. This inflammatory complication may become chronic or recur in multiple episodes. 

Objetivo (s)

In this study, we assess neutrophilic leukocytosis in a retrospective cohort of patients affected by BL or LL leprosy and its correlation with Neutrophil-to-Lymphocyte Ratio (NLR) levels and ENL severity.

Material e Métodos

A retrospective observational study was performed using data and samples from 146 patients with BL and LL leprosy diagnosed and treated at the Souza Araújo Outpatient Clinic, Fiocruz, Rio de Janeiro, Brazil, from 2009 until 2019. Clinical, demographic, and hematological data were collected from medical records. Histopathological and immunohistochemical evaluations were carried out in skin lesion biopsy samples from patients with ENL.

Resultados e Conclusão

Most patients were male (75%) and had a reactional episode (85%), of which 65% were ENL. 69 of 80 (55%) patients with ENL presented more than 2 episodes (average of 2.6 episodes). The median blood neutrophil counts of treatment-naive patients with BL/LL who developed ENL later were higher than those who did not experience any reaction. The increase in median neutrophil counts was correlated to ENL severity. We demonstrated the presence of neutrophilic leukocytosis in ENL episodes and found that an increased NLR was associated with more significant neutrophilic infiltration in skin lesions.  In conclusion, our study provides evidence that ENL episodes in patients affected by leprosy are linked to elevated blood leukocyte and neutrophil counts, as well as an increased NLR.

Palavras Chave

Leprosy; ENL; Neutrophil; NLR