PERIPHERAL VASCULAR DEFICIT IN LEPROSY

  • 1 January 1976
    • journal article
    • research article
    • Vol. 44  (3) , 332-339
Abstract
There is considerable controversy regarding the frequency and significance of vascular lesions in leprosy. Leprosy patients (35) under 40 yr of age, without any local and systemic arterial disease, with normal looking hands and feet, were subjected to brachial arteriography. One patient also had posterior tibial arteriography. Diagnosis of leprosy was confirmed by bacteriologic and histopathologic technique. Biopsy material was studied from the area of radiographic abnormality, similar material was obtained from 9 matched control subjects at autopsy. Skin thermometry and reflex vasodilatation were studied in 8 cases. Various fractions of serum lipids and cholesterol were estimated in all patients and found to be within normal rage. Arteriographic abnormalities such as occlusion, narrowing, tortuosity, dilatation, poststenotic dilatation, irregularity and incomplete filling of the lumen by radio-opaque material, were seen in more than 2 vessels in 50% of the arteriograms in wrist and palm; digital vessels showed abnormality in 75% to 94% of cases. The ulnar artery was more frequently involved (74%) than the radial (50%). Superficial and deep palmar arches were equally affected. Increased vascularity in hypothenar eminence area was seen in 3 arteriograms. Marked increase in arcuate vessels was noted in 60% of patients. Some arcuate vessels were serving as collaterals. Histologically, all grades of vessels including capillaries showed changes in nearly half of the patients. Reflex vasodilatation was lost in 3 patients of dimorphous leprosy, and impaired or absent in 3 of 5 patients of lepromatous leprosy. There was no predilection for any form of leprosy show arterial changes more than others. This study clearly demonstrates that the vascular involvement in leprosy is very frequent and must be important in causing deformities of hands and feet.