Anti-phospholipid syndrome in seven leprosy patients with thrombotic events on corticosteroid and/or thalidomide regimen: insights on genetic and laboratory profiles

Rev Soc Bras Med Trop. 2018 Jan-Feb;51(1):99-104. doi: 10.1590/0037-8682-0216-2017.

Abstract

Introduction: Corticosteroids and/or thalidomides have been associated with thromboembolism events (TBE) in multibacillary (MB) leprosy. This report aimed to determine genetic and laboratory profiles associated with leprosy and TBE.

Methods: Antiphospholipid antibodies (aPL), coagulation-related exams, prothrombin and Leiden's factor V mutations, and ß2-glycoprotein-I (ß2GPI) Val247Leu polymorphism were assessed.

Results: Six out of seven patients with leprosy were treated with prednisone and/or thalidomide during TBE and presented at least one positive aPL. All patients presented ß2GPI polymorphism, and one showed prothrombin mutation.

Conclusions: Corticosteroid or thalidomide adverse effects and aPL and ß2GPI polymorphisms may cause TBE in patients with MB leprosy.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage*
  • Adrenal Cortex Hormones / adverse effects
  • Adult
  • Aged
  • Antibodies, Antiphospholipid / blood
  • Antibodies, Antiphospholipid / drug effects
  • Antibodies, Antiphospholipid / genetics
  • Antiphospholipid Syndrome* / blood
  • Antiphospholipid Syndrome* / drug therapy
  • Antiphospholipid Syndrome* / genetics
  • Enzyme-Linked Immunosorbent Assay
  • Factor V / analysis
  • Female
  • Humans
  • Immunoglobulin G / blood
  • Immunoglobulin M / blood
  • Leprosy, Multibacillary / drug therapy
  • Leprosy, Multibacillary / genetics
  • Leprosy, Multibacillary / immunology*
  • Male
  • Middle Aged
  • Mutation
  • Polymorphism, Genetic
  • Prothrombin / analysis
  • Thalidomide / administration & dosage*
  • Thalidomide / adverse effects
  • Venous Thromboembolism / drug therapy
  • beta 2-Glycoprotein I / blood

Substances

  • Adrenal Cortex Hormones
  • Antibodies, Antiphospholipid
  • Immunoglobulin G
  • Immunoglobulin M
  • beta 2-Glycoprotein I
  • factor V Leiden
  • Thalidomide
  • Factor V
  • Prothrombin