Epidemiological Immunological Studies on Leprosy in Okinawa:IV. Relationships between Mitsuda's Reaction and Each of Personal, Family Histories and Clinical Findings of Inpatient
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概要
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A total of 502 patients with leprosy admitted in the National Leprosaria, Okinawa Airaku-en and Miyako Nansei-en, were tested by the standard lepromin (160 million bacil-li/ml) and the sizes of Mitsuda's reactions read after 4 weeks were classified by 4 groups, i.e., 0-2mm, 3-5mm, 6-9mm, 10mm and larger. These groups were subdivided by per-sonal or family history or clinical findings of each patient. A relationship between each of these findings and Mitsuda's reactions was examined by χ2 test. High responders (10 mm and larger) were more frequently found in female than in male. Average age tended to rise with the increasing reactivity, but the highest average age was seen in non-lepro-matous patients with the lowest (0-2mm) response. This fact suggests a reduced lepro-min-reactivity in the aged patients.High responders were less frequently found in the patients whose parents had inter-married. Among 31 pairs of consanguineous patients, 10 pairs showed a similarity of lepro-min-reactivity which was not concordant with the classification of leprosy, whereas the similar reactivity was found in only 2 out of 31 pairs of patients without blood-relation-ship, but with the same sex, age and classification of leprosy as the consanguineous pairs. The difference was statistically significant. However, the presence or absence of consan-guineous patient did not correlate with the lepromin-reactivity of index cases.A living place and the place of onset showed no significant correlation with the Mitsuda's reaction. Thehigh responders were more frequently found in the patients with longer duration of disease than in those with the shorter, but this correlation was not sig-nificant in the patients with lepromatous leprosy. Low responders showed significant correlations with the initial symptoms such as cutaneous swelling and nodules, frequencies of skin lesion and ENL, positive bacteriological finding and the enlargement of peripheral nerve, while high responders showed significant correlations with the frequencies of claw hand, drop foot and complication of the other diseases. The Mitsuda's reaction in lepro-matous patients did not correlate with the symptoms such as the fall of eyebrow, ocular, nasal involvements and planter ulcer. Irregular and stopped treatments were more frequently found in the high responders. However, continued treatment of lepromatous cases showed no significant correlation with the lepromin-reactivity. These results suggest that the Mitsuda's reaction of leprosy patients in Okinawa are significantly influenced by both genetic and acquired factors, though the influence in some cases may be masked by an elevated level of lepromin-reactivity in the Okinawan patients as described in a previous report.
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