C-REACTIVE PROTEINS IN LEPROSY

I. The Parallelism between the C-reactive Protein and Erythema Nodosum Leprosum

Abstract

The C-reactive protein (CRP) test was applied to the sera of 291 leprosy patients, among which. 250 were of the lepromatous and 41 of the tuberculoid type. CRP tests in the 84 lepromatous cases which were in the state of Erythema Nodosum Leprosum (ENL), showed 72 cases (85.7%) to be positive and 12 (14.3%) negative. On the contrary, no CRP was found in the sera of 27 cases which were in the state of lepromatous exacervation and of 4 cases of "Epithelioid Reaction" (Hirako), i. e. the other type of lepra reactions including "Pseudoexacervation" (Souza-Lima) and "Acute Infiltration" (Tajiri). Only two cases (1.5%) were positive in residual 135 leproma tous patients who were not in the reactional state at the test, though many of the cases hadd experienced ENL. Of the 41 tuberculoid cases, only one (2.4%) was positive and 40 (97.6%) were negative.
CRP was abscent in sera of ENL patients whose symptoms were relatively light' while always present in the severe cases. Repeated CRP tests in certain ENL patients showed that CRP appeared in serum within a few days after the onset of ENL and disappeared at the arrested stage. These findings suggest that the CRP test will be useful for the differentiation of ENL from the other lepra reactions and as an indication for cortisone treatment of ENL.