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Abstract

Leprosy is still an endemic disease, especially in Third World countries, and, because of migration, it still persists in Europe and the United States. The disease affects the peripheral nerves, skin, and multiple internal organs, making its clinical recognition difficult. In particular, the endocrine manifestations caused by leprosy have been underestimated, even by specialists. The endocrine changes present in leprosy include hypogonadism, sterility, and osteoporosis. In addition, the spectral immune nature of leprosy offers an attractive model to investigate the pathogenetic correlation between the patterns of inflammation in the poles of its spectrum and the hormonal disarrangements observed in this disease. It is important that those involved in leprosy management be aware of the potential endocrine changes and their treatment to address the disease in all of its aspects. In this article, we review the findings on endocrine dysfunction in leprosy, including a survey of the literature and of our own work.

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References

  1. Gill AL, Bell DR, Gill GV, Wyatt GB, Beeching NJ (2005) Leprosy in Britain: 50 years experience in Liverpool. Q J Med 98:505–511

    CAS  Google Scholar 

  2. Ooi WW, Moschella SL (2001) Update on leprosy in immigrants in the United States: status in the year 2000. Clin Infect Dis 32:930–937. doi:10.1086/319357

    PubMed  CAS  Google Scholar 

  3. Walker SL, Lockwood DNJ (2006) The clinical and immunological features of leprosy. Br Med Bull 77–78:103–121. doi:10.1093/bmb/ldl010

    PubMed  Google Scholar 

  4. Britton WJ, Lockwood DNJ (2004) Leprosy. Lancet 363:1209–1219. doi:10.1016/S0140-6736(04)15952-7

    PubMed  Google Scholar 

  5. Ridley DS, Jopling WH (1966) Classification of leprosy according to immunity. A five-group system. Int J Lepr Other Mycobact Dis 34:255–273

    PubMed  CAS  Google Scholar 

  6. Powell CS, Swan LL (1955) Leprosy: pathologic changes observed in fifty consecutive necropsies. Am J Pathol 31:1131–1147

    PubMed  CAS  Google Scholar 

  7. Desikan KV, Job CK (1968) A review of postmortem findings in 37 cases of leprosy. Int J Lepr Other Mycobact Dis 36:32–44

    PubMed  CAS  Google Scholar 

  8. Bernard JC, Vazquez CAJ (1973) Visceral lesions in lepromatous leprosy. Study of sixty necropsies. Int J Lepr Other Mycobact Dis 41:94–101

    PubMed  CAS  Google Scholar 

  9. Balybin ES, Nazarov KI (1983) Hydrocortisone production in lepromatous patients with insulin load. Int J Lepr Other Mycobact Dis 51:18–21

    PubMed  CAS  Google Scholar 

  10. Durairaj V, Radhabai K, Alagappan R, Koteeswaran A, Venkataraman V, Kannan K (1984) Adrenal cortical function and reserve in lepromatous leprosy. Indian J Lepr 56:828–834

    PubMed  CAS  Google Scholar 

  11. Saha K, Rao KN, Sehgal VN, Gadi S, Jain VK, Chakrabarty AK (1985) Radioimmunoassay of serum cortisol levels in leprosy patients with special reference to type I and type II reaction. Lepr Rev 56:117–125

    PubMed  CAS  Google Scholar 

  12. Colak R, Ozkan Y, Onen SE, Saral Y, Halifeoglu I (2005) A comparison between the effects of low (1 μg) and standard dose (250 μg) ACTH stimulation tests on adrenal cortex functions with leprosy patients. Endocr Res 31:325–333. doi:10.1080/07435800500449478

    CAS  Google Scholar 

  13. Garg R, Agrawal JK, Bajpai HS, Singh G, Srivastava PK (1988) Adreno-cortical function in leprosy. Indian J Lepr 60:609–615

    PubMed  CAS  Google Scholar 

  14. Goldgraber MB, Sulman FG (1969) Adrenal cortical dysfunction in leprosy. Int J Lepr Other Mycobact Dis 37:351–358

    PubMed  CAS  Google Scholar 

  15. Leal AMO, Magalhães PKR, Souza CS, Foss NT (2003) Adrenocortical hormones and interleukin patterns in leprosy. Parasite Immunol 25:457–461. doi:10.1111/j.1365-3024.2003.00654.x WH

    PubMed  CAS  Google Scholar 

  16. Leal AMO, Magalhães PKR, Martinez R, Moreira AC (2003) Adrenocortical hormones and interleukin patterns in paracoccidioidomycosis. J Infect Dis 187:124–127. doi:10.1086/345872

    PubMed  CAS  Google Scholar 

  17. Bornstein SR, Chrousos GP (1999) Adrenocorticotropin (ACTH)- and non-ACTH-mediated regulation of the adrenal cortex: neural and immune inputs. J Clin Endocrinol Metab 84:1729–1736. doi:10.1210/jc.84.5.1729

    PubMed  CAS  Google Scholar 

  18. Päth G, Scherbaum WA, Bornstein SR (2000) The role of interleukin-6 in the human adrenal gland. Eur J Clin Invest 30:91–95. doi:10.1046/j.1365-2362.2000.0300s3091.x

    PubMed  Google Scholar 

  19. Päth G, Bornstein SR, Ehrhardt-Bornstein M, Scherbaum WA (1997) Interleukin-6 and the interleukin-6 receptor in the human adrenal gland: expression and effects on steroidogenesis. J Clin Endocrinol Metab 82:2343–2349. doi:10.1210/jc.82.7.2343

    PubMed  Google Scholar 

  20. Parker LN, Levin ER, Lifrak ET (1985) Evidence for adrenocortical adaptation to severe illness. J Clin Endocrinol Metab 60:947–952

    PubMed  CAS  Google Scholar 

  21. Daynes RA, Dudley DJ, Araneo BA (1990) Regulation of murine lymphokine production in vivo. II. Dehydroepiandrosterone is a natural enhancer of interleukin 2 synthesis by helper T cells. Eur J Immunol 20:793–802. doi:10.1002/eji.1830200413

    PubMed  CAS  Google Scholar 

  22. Suzuki T, Suzuki N, Daynes RA, Engleman EG (1991) Dehydroepiandrosterone enhances IL2 production and cytotoxic effector function of human T cells. Clin Immunol Immunopathol 61:202–211. doi:10.1016/S0090-1229(05)80024-8

    PubMed  CAS  Google Scholar 

  23. Padgett DA, Loria RM (1994) In vitro potentiation of lymphocyte activation by dehydroepiandrosterone, androstenediol, and androstenetriol. J Immunol 153:1544–1552

    PubMed  CAS  Google Scholar 

  24. Rook GAW, Baker R (1999) Cortisol metabolism, cortisol sensitivity and the pathogenesis of leprosy reactions. Trop Med Int Health 4:493–498. doi:10.1046/j.1365-3156.1999.00432.x

    PubMed  CAS  Google Scholar 

  25. Andersson AK, Atkinson SE, Khanolkar-Young S, Chaduvula M, Jain S, Suneetha L, Suneetha S, Lockwood DN (2007) Alteration of the cortisol–cortisone shuttle in leprosy type 1 reactions in leprosy patients in Hyderabad, India. Immunol Lett 109:72–75. doi:10.1016/j.imlet.2007.01.004

    PubMed  CAS  Google Scholar 

  26. Baptista L (1937) A gynecomastia na lepra. Rev Brasil Leprol 5:53–66

    Google Scholar 

  27. Rée GH, Martin F, Myles K, Peluso I (1981) Hormonal changes in human leprosy. Lepr Rev 52:121–126

    PubMed  Google Scholar 

  28. Levis WR, Lanza AP, Swersie S, Meeker HC, Schuller-Levis GB, Bardin CW (1989) Testicular dysfunction in leprosy: relationships of FSH, LH and testosterone to disease classification, activity and duration. Lepr Rev 60:94–101

    PubMed  CAS  Google Scholar 

  29. Grabstald H, Swan LL (1952) Genitourinary lesions in leprosy, with special reference to the problem of atrophy of the testes. JAMA 119:1287–1291

    CAS  Google Scholar 

  30. Job CK (1961) Gynecomastia and leprous orchitis. A preliminary study. Int J Lepr Other Mycobact Dis 29:423–441

    Google Scholar 

  31. Ibrahiem AA, Awad HA, Metawi BA, Hamada TAY (1979) Pathologic changes in testis and epididymis of infertile leprotic males. Int J Lepr Other Mycobact Dis 47:44–49

    PubMed  CAS  Google Scholar 

  32. Saporta L, Yuksel A (1994) Androgenic status in patients with lepromatous leprosy. Br J Urol 74:221–224

    PubMed  CAS  Google Scholar 

  33. Kannan V, Vijaya G (1984) Endocrine testicular functions in leprosy. Horm Metab Res 16:146–150

    PubMed  CAS  Google Scholar 

  34. Akhtar M, Ali MA, Mackey DM (1980) Lepromatous leprosy presenting as orchitis. Am J Clin Pathol 73:712–715

    PubMed  CAS  Google Scholar 

  35. Job CK, Macaden VP (1963) Leprous orchitis in reactional borderline cases. Int J Lepr Other Mycobact Dis 31:273–279

    CAS  Google Scholar 

  36. Singh N, Arora VK, Jain A, Bhattacharya SN, Bhatia A (2002) Cytology of testicular changes in leprosy. Acta Cytol 46:659–663

    PubMed  Google Scholar 

  37. Neena K, Ammini AC, Singh M, Pandhi RK (2003) Ovarian function in female patients with multibacillary leprosy. Int J Lepr Other Mycobact Dis 71:101–105. doi:10.1489/1544-581X(2003)071<0101:OFIFPW>2.0.CO;2

    PubMed  Google Scholar 

  38. Rea TH (1988) A comparative study of testicular involvement in lepromatous and borderline lepromatous leprosy. Int J Lepr Other Mycobact Dis 56:383–388

    PubMed  CAS  Google Scholar 

  39. Dash RJ, Kumar B, Sialy R, Rastogi GK (1979) LH, FSH responses to GnRH in lepromatous leprosy. Horm Metab Res 11:413–414

    PubMed  CAS  Google Scholar 

  40. Shilo S, Livshin Y, Sheskin J, Spitz IM (1981) Gonadal function in lepromatous leprosy. Lepr Rev 52:127–134

    PubMed  CAS  Google Scholar 

  41. Morley JE, Distiller LA, Sagel J, Kok SH, Kay G, Carr P, Katz M (1977) Hormonal changes associated with testicular atrophy and gynaecomastia in patients with leprosy. Clin Endocrinol (Oxf) 6:299–303. doi:10.1111/j.1365-2265.1977.tb02015.x

    CAS  Google Scholar 

  42. Sultan Sheriff D (1984) Endocrine profile and seminal plasma composition in Hansen’s disease. Trans R Soc Trop Med Hyg 78:311–313. doi:10.1016/0035-9203(84)90103-2

    PubMed  CAS  Google Scholar 

  43. Rolston R, Mathews M, Taylor PM, Koshy TS (1981) Hormone profile in lepromatous leprosy. A preliminary study. Int J Lepr Other Mycobact Dis 49:31–36

    PubMed  CAS  Google Scholar 

  44. Leal AMO, Magalhães PKR, Souza CS, Foss NT (2006) Pituitary-gonadal hormones and interleukin patterns in leprosy. Trop Med Int Health 11:1416–1421. doi:10.1111/j.1365-3156.2006.01692.x

    PubMed  CAS  Google Scholar 

  45. Garg R, Agarwal JK, Singh G, Bajpai HS (1989) Hormone profile in leprosy. Indian J Lepr 61:428–431

    PubMed  CAS  Google Scholar 

  46. Dass J, Murugesan K, Laumas KR, Deo MG, Kandhari KC, Bhutani LK (1976) Androgenic status of lepromatous leprosy patients with gynecomastia. Int J Lepr Other Mycobact Dis 44:469–474

    PubMed  CAS  Google Scholar 

  47. Kinnear AA, Davison AR (1957) Hormone excretion and liver function in the gynecomastia of leprosy. Int J Lepr Other Mycobact Dis 25:110–118

    CAS  Google Scholar 

  48. Abraham A, Sharma VK, Kaur S (1990) Assessment of testicular volume in bacilliferous leprosy: correlation with clinical parameters. Indian J Lepr 62:310–315

    PubMed  CAS  Google Scholar 

  49. Kumar A, Bagghi CS, Indrayan A (1973) Impact of lepromatous leprosy on fecundity. Fertil Steril 24:324–325

    PubMed  CAS  Google Scholar 

  50. Faulstich ME (1985) Behavioral analysis of sexual dysfunction in Hansen’s disease. Percept Mot Skills 60:115–118

    PubMed  CAS  Google Scholar 

  51. El-Shiemy S, El-Hefnawi H, Abdel-Fattah A, El-Okbi M, Farid A (1976) Testicular and epididymal involvement in leprosy patients, with special reference to gynecomastia. Int J Dermatol 15:52–58. doi:10.1111/j.1365-4362.1976.tb05097.x

    PubMed  CAS  Google Scholar 

  52. Martin FIR, Maddocks I, Brown JB, Hudson B (1968) Leprous endocrinopathy. Lancet 2:1320–1321. doi:10.1016/S0140-6736(68)91817-5

    PubMed  CAS  Google Scholar 

  53. Iyer C, Languillon J, Ramanujam G, Tarabini-Castellani G, De las Aguas JT, Bechelli LM, Uemura K, Martinez Dominguez V, Sundaresan T (1971) WHO co-ordinated short-term double-blind trial with thalidomide in the treatment of acute lepra reactions in male lepromatous patients. Bull World Health Organ 45:719–732

    PubMed  CAS  Google Scholar 

  54. Brand PW (1959) Temperature variation and leprosy deformity. Int J Lepr Other Mycobact Dis 27:1–7

    CAS  Google Scholar 

  55. Wall JR, Wright DJM (1974) Antibodies against testicular germinal cells in lepromatous leprosy. Clin Exp Immunol 17:51–59

    PubMed  CAS  Google Scholar 

  56. Saha K, Gupta I (1977) Immunologic aspects of leprosy with special reference to the circulating antispermatozoal antibodies. Int J Lepr Other Mycobact Dis 45:28–37

    PubMed  CAS  Google Scholar 

  57. Wall JR, Walters BAJ (1981) Immunoreactivity in vitro to human testis in patients with lepromatous leprosy. Aust N Z J Med 11:375–379

    PubMed  CAS  Google Scholar 

  58. Mealy K, Robinson B, Millette CF, Majzoub J, Wilmore DW (1990) The testicular effects of tumor necrosis factor. Ann Surg 211:470–475. doi:10.1097/00000658-199004000-00014

    PubMed  CAS  Google Scholar 

  59. Lin T, Wang TL, Nagpal ML, Calkins JH, Chang WW, Chi R (1991) Interleukin-1 inhibits cholesterol side-chain cleavage cytochrome P450 expression in primary cultures of Leydig cells. Endocrinology 129:1305–1311

    PubMed  CAS  Google Scholar 

  60. Mauduit C, Hartmann DJ, Chauvin MA, Revol A, Morera AM, Benahmed M (1991) Tumor necrosis factor alpha inhibits gonadotropin action in cultured porcine Leydig cells: site(s) of action. Endocrinology 129:2933–2940

    PubMed  CAS  Google Scholar 

  61. Hales DB, Xiong Y, Tur-Kaspa I (1992) The role of cytokines in the regulation of Leydig cell P450c17 gene expression. J Steroid Biochem Mol Biol 43:907–914. doi:10.1016/0960-0760(92)90318-D

    CAS  Google Scholar 

  62. Hales DB (2002) Testicular macrophage modulation of Leydig cell steroidogenesis. J Reprod Immunol 57:3–18. doi:10.1016/S0165-0378(02)00020-7

    PubMed  CAS  Google Scholar 

  63. Hedger MP, Meinhardt A (2003) Cytokines and the immune-testicular axis. J Reprod Immunol 58:1–26. doi:10.1016/S0165-0378(02)00060-8

    PubMed  CAS  Google Scholar 

  64. Morales V, Santana P, Diáz R, Tabraue C, Gallardo G, López Blanco F, Hernández I, Fanjul LF, Ruiz de Galarreta CM (2003) Intratesticular delivery of tumor necrosis factor-alpha and ceramide directly abrogates steroidogenic acute regulatory protein expression and Leydig cell steroidogenesis in adult rats. Endocrinology 144:4763–4772. doi:10.1210/en.2003-0569

    PubMed  CAS  Google Scholar 

  65. Olsen NJ, Kovacs WJ (1996) Gonadal steroids and immunity. Endocr Rev 17:369–384. doi:10.1210/er.17.4.369

    PubMed  CAS  Google Scholar 

  66. Cutolo M, Seriolo B, Villaggio B, Pizzorni C, Craviotto C, Sulli A (2002) Androgens and estrogens modulate the immune and inflammatory responses in rheumatoid arthritis. Ann N Y Acad Sci 966:131–142

    PubMed  CAS  Google Scholar 

  67. Zofková I, Kancheva RL, Hampl R (1995) A decreasing CD4+/CD8+ ratio after one month of treatment with stanazolol in postmenopausal women. Steroids 60:430–433. doi:10.1016/0039-128X(94)00036-C

    PubMed  Google Scholar 

  68. Cutolo M, Balleari E, Giusti M, Intra E, Accardo S (1991) Androgen replacement therapy in male patients with rheumatoid arthritis. Arthritis Rheum 34:1–5. doi:10.1002/art.1780340102

    PubMed  CAS  Google Scholar 

  69. Couri CEB, Foss NT, Dos Santos CS, de Paula FJA (2004) Hypercalcemia secondary to leprosy. Am J Med Sci 328:357–359

    PubMed  Google Scholar 

  70. Ryzen E, Rea TH, Singer FR (1988) Hypercalcemia and abnormal 1,25-dihydroxyvitamin D concentrations in leprosy. Am J Med 84:325–329. doi:10.1016/0002-9343(88)90434-2

    PubMed  CAS  Google Scholar 

  71. Rao KN, Saha K (1986) Undernutrition in lepromatous leprosy, Part II. Altered levels of serum elements. Their association with the disease and not with food deprivation. Lepr Rev 57:311–316

    PubMed  CAS  Google Scholar 

  72. Hoffman VN, Korzeniowski OM (1986) Leprosy, hypercalcemia, and elevated serum calcitriol levels. Ann Intern Med 105:890–891

    PubMed  CAS  Google Scholar 

  73. Vidal MC, Botasso OA, Lehrer A, Puche RC (1993) Altered calcium-binding ability of plasma proteins as the cause of hypocalcemia in lepromatous leprosy. Int J Lepr Other Mycobact Dis 61:586–591

    PubMed  CAS  Google Scholar 

  74. Mautalen CA, Vaquero NL, Zeni SN, Mendez MA, Gonzalez DC, Bagur AC, Casco CA, Ladizesky MG (1994) Calcium metabolism and its regulating hormones in patients with leprosy. Int J Lepr Other Mycobact Dis 62:580–585

    PubMed  CAS  Google Scholar 

  75. Ryzen E, Singer FR (1985) Hypercalcemia in leprosy. Arch Intern Med 145:1305–1306. doi:10.1001/archinte.145.7.1305

    PubMed  CAS  Google Scholar 

  76. Barbour GL, Coburn JW, Slatopolsky E, Norman AW, Horst RL (1991) Hypercalcemia in an anephric patient with sarcoidosis: evidence for extrarenal generation of 1,25-dihydroxyvitamin D. N Engl J Med 305:440–443

    Google Scholar 

  77. Parker MS, Dokoh S, Woolfenden JM, Buchsbaum HW (1984) Hypercalcemia in coccidioidomycosis. Am J Med 76:341–344. doi:10.1016/0002-9343(84)90799-X

    PubMed  CAS  Google Scholar 

  78. Abbasi AA, Chemplavil JK, Farah S, Muller BF, Arnstein AR (1979) Hypercalcemia in active pulmonary tuberculosis. Ann Intern Med 90:324–328

    PubMed  CAS  Google Scholar 

  79. Bell NH, Stern PH, Pantzer E, Sinha TK, Deluca HF (1979) Evidence that increased circulating 1α,25-dihydroxyvitamin D is the probable cause for abnormal calcium metabolism in sarcoidosis. J Clin Invest 64:218–225. doi:10.1172/JCI109442

    PubMed  CAS  Google Scholar 

  80. Adams JS, Sharma OP, Gacad MA, Singer FR (1983) Metabolism of 25-hydroxyvitamin D3 by cultured pulmonary alveolar macrophages in sarcoidosis. J Clin Invest 72:1856–1860. doi:10.1172/JCI111147

    PubMed  CAS  Google Scholar 

  81. Mason RS, Frankel T, Chan YL, Lissner D, Posen S (1984) Vitamin D conversion by sarcoid lymph node homogenate. Ann Intern Med 100:59–61

    PubMed  CAS  Google Scholar 

  82. Lips P (2006) Vitamin D physiology. Prog Biophys Mol Biol 92:4–8. doi:10.1016/j.pbiomolbio.2006.02.016

    PubMed  CAS  Google Scholar 

  83. Paterson DE, Rad M (1961) Bone changes in leprosy, their incidence, progress, prevention and arrest. Int J Lepr Other Mycobact Dis 29:393–422

    CAS  Google Scholar 

  84. Thappa DM, Sharma VK, Kaur S, Suri S (1992) Radiological changes in hands and feet in disabled leprosy patients: a clinico-radiological correlation. Indian J Lepr 62:58–66

    Google Scholar 

  85. Choudhuri H, Thappa DM, Kumar RH, Elangovan S (1999) Bone changes in leprosy patients with disabilities/deformities (a clinico-radiological correlation). Indian J Lepr 71:203–215

    PubMed  CAS  Google Scholar 

  86. Ishikawa S, Ishikawa A, Yoh K, Tanaka H, Fujiwara M (1999) Osteoporosis in male and female leprosy patients. Calcif Tissue Int 64:144–147. doi:10.1007/s002239900593

    PubMed  CAS  Google Scholar 

  87. Ishikawa A, Tanaka H, Mizushima M, Hashizume H, Ishida Y, Inoue H (1997) Osteoporosis due to testicular atrophy in male leprosy patients. Acta Med Okayama 51:279–283

    PubMed  CAS  Google Scholar 

  88. Ishikawa S, Mizushima M, Furuta M, Ishikawa A, Kawamura K (2000) Leydig cell hyperplasia and the maintenance of bone volume: bone histomorphometry and testicular histopathology in 29 male leprosy autopsy cases. Int J Lepr Other Mycobact Dis 68:258–266

    PubMed  CAS  Google Scholar 

  89. Ishikawa A, Ishikawa S, Hirakawa M (2001) Osteoporosis, bone turnover and hypogonadism in elderly men with treated leprosy. Lepr Rev 72:322–329

    PubMed  CAS  Google Scholar 

  90. Walker SL, Waters MFR, Lockwood DNJ (2007) The role of thalidomide in the management of erythema nodosum leprosum. Lepr Rev 78:197–215

    PubMed  Google Scholar 

  91. Ribeiro FB, Pereira F de A, Muller E, Foss NT, de Paula FJ (2007) Evaluation of bone and mineral metabolism in patients recently diagnosed with leprosy. Am J Med Sci 334:322–326

    Article  PubMed  Google Scholar 

  92. Clowes JA, Riggs BL, Khosla S (2005) The role of the immune system in the pathophysiology of osteoporosis. Immunol Rev 208:207–227. doi:10.1111/j.0105-2896.2005.00334.x

    PubMed  CAS  Google Scholar 

  93. Kanaji A, Higashi M, Namisato M, Ando K, Nakagawa M, Yato Y, Ichinose H, Sakamaki T, Yamada H (2005) Trochanteric hip fracture in an elderly patient with leprosy during osteoporosis treatment with risedronate and alfacalcidol. J Bone Miner Metab 23:90–94. doi:10.1007/s00774-004-0546-7

    PubMed  Google Scholar 

  94. Kanaji A, Higashi M, Namisato M, Nishio M, Ando K, Yamada H (2006) Effects of risedronate on lumbar bone mineral density, bone resorption, and incidence of vertebral fracture in elderly male patients with leprosy. Lepr Rev 77:147–153

    PubMed  Google Scholar 

  95. Yumnam IS, Kaur S, Kumar B, Rastogi GK (1977) Evaluation of thyroid functions in leprosy. I. Thyroid function tests. Lepr India 49:485–491

    PubMed  CAS  Google Scholar 

  96. Garg R, Agarwal JK, Singh G, Bajpai HS (1990) Thyroid function in leprosy. Indian J Lepr 62:215–218

    PubMed  CAS  Google Scholar 

  97. Kheir MM, Ahmed AM, Elsarrag AA (2001) Thyroid functional status in leprosy patients in Sudan. East Mediterr Health J 7:79–83

    PubMed  CAS  Google Scholar 

  98. Larsen PR, Davies TF, Schlumberger M-J, Hay ID (2002) Thyroid physiology and diagnostic evaluation of patients with thyroid disorders. In: Larsen PR, Kronenberg HM, Melmed S, Polonsky KS, Wilson JD, Foster DW (eds) Williams textbook of endocrinology, 10th edn. Saunders, Philadelphia, PA

    Google Scholar 

  99. Bonomo L, Dammacco F, Pinto L, Babieri G (1963) Thyroglobulin antibodies in leprosy. Lancet 2:807–809. doi:10.1016/S0140-6736(63)90501-4

    PubMed  CAS  Google Scholar 

  100. Shwe T (1972) Clinical significance of autoimmune antibodies in leprosy. Trans R Soc Trop Med Hyg 66:749–753. doi:10.1016/0035-9203(72)90089-2

    PubMed  CAS  Google Scholar 

  101. Pradhan V, Badakere SS, Shankar Kumar U (2004) Increased incidence of cytoplasmic ANCA (cANCA) and other autoantibodies in leprosy patients from western India. Lepr Rev 75:50–56

    PubMed  Google Scholar 

  102. Badros AF, Siegel E, Bodenner D, Zangari M, Zeldis J, Barlogie B, Tricot G (2002) Hypothyroidism in patients with multiple myeloma following treatment with thalidomide. Am J Med 112:412–413. doi:10.1016/S0002-9343(01)01137-8

    PubMed  Google Scholar 

  103. Nigam P, Dayal SG, Srivastava P, Joshi LD, Goyal BM, Dutt B, Gupta MC (1979) Diabetic status in leprosy. Hansenol Int 4:7–14

    PubMed  CAS  Google Scholar 

  104. Garg R, Agrawal JK, Bajpai HS, Singh G, Srivastava PK (1990) Glucose tolerance test in leprosy. Indian J Lepr 62:50–54

    PubMed  CAS  Google Scholar 

  105. Marik PE, Rahavan M (2004) Stress-hyperglycemia, insulin and immunomodulation in sepsis. Intensive Care Med 30:748–756. doi:10.1007/s00134-004-2167-y

    PubMed  Google Scholar 

  106. Sugumaran DS (1998) Leprosy reactions—complications of steroid therapy. Int J Lepr Other Mycobact Dis 66:10–15

    PubMed  CAS  Google Scholar 

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Leal, Â.M.O., Foss, N.T. Endocrine dysfunction in leprosy. Eur J Clin Microbiol Infect Dis 28, 1–7 (2009). https://doi.org/10.1007/s10096-008-0576-5

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