Efficacy of Multidrug Therapy (MDT) and exclusion of transplacental transmission in a pregnant woman with multibacillary leprosy

Abstract

Leprosy in pregnancy is a rare occurrence. The evidence of transplacental transmission of leprosy in animal models brings anxiety regarding the potential impact on the fetus. This case report shows the steps taken to detect possible transplacental transmission of leprosy and evaluate the efficacy of multidrug therapy (MDT) in a pregnant woman. We report a case of a 19-year-old Indonesian woman, in the third trimester of pregnancy, diagnosed with borderline tuberculoid multibacillary (MB) leprosy. She had been on MDT since the 38th week of pregnancy. We evaluated the transplacental transmission and assessed the efficacy of MDT by comparing IgM anti-phenolic glycolipid-1 (PGL-1) antibody levels over time. Serological testing showed no anti-PGL-1 IgM antibodies in the umbilical cord blood, and histopathological examination found no acid-fast bacilli (AFB) in placental and umbilical cord tissues. MDT was effective in reducing BI, MI, and IgM anti-PGL-1 levels in the patient. MDT is safe for use during pregnancy. No perinatal complications were reported.