Leprosy nephropathy: a review of clinical and histopathological features

• Published in: Revista do Instituto de Medicina Tropical de São Paulo Vol. 57; no. 1; pp. 15 - 20
• Main Authors: Silva Junior, Geraldo Bezerra da, Daher, Elizabeth De Francesco, Pires Neto, Roberto da Justa, Pereira, Eanes Delgado Barros, Meneses, Gdayllon Cavalcante, Araújo, Sônia Maria Holanda Almeida, Barros, Elvino José Guardão
• Format: Journal Article
• Language: English; Portuguese
• Published: Brazil Instituto de Medicina Tropical de Sao Paulo 01.01.2015; Instituto de Medicina Tropical; Universidade de São Paulo (USP)
• Subjects: Chronic kidney disease; Glomerulonephritis; Hansen disease; Humans; Kidney Diseases - microbiology; Kidney Diseases - pathology; Kidney dysfunction; Leprosy; Leprosy - complications; Leprosy - pathology; Mycobacterium leprae; Review; TROPICAL MEDICINE; Glomerulonephritis; Leprosy; Kidney dysfunction; Chronic kidney disease; Hansen disease
• ISSN: 0036-4665; 1678-9946; 1678-9946; 0036-4665
• DOI: 10.1590/S0036-46652015000100002

Leprosy is a chronic disease caused by Mycobacterium leprae, highly incapacitating, and with systemic involvement in some cases. Renal involvement has been reported in all forms of the disease, and it is more frequent in multibacillary forms. The clinical presentation is variable and is determined by the host immunologic system reaction to the bacilli. During the course of the disease there are the so called reactional states, in which the immune system reacts against the bacilli, exacerbating the clinical manifestations. Different renal lesions have been described in leprosy, including acute and chronic glomerulonephritis, interstitial nephritis, secondary amyloidosis and pyelonephritis. The exact mechanism that leads to glomerulonephritis in leprosy is not completely understood. Leprosy treatment includes rifampicin, dapsone and clofazimine. Prednisone and non-steroidal anti-inflammatory drugs may be used to control acute immunological episodes.