Radioimmunoassay of serum cortisol levels in leprosy patients with special reference to type I and type II reaction

Abstract

In the present paper, an attempt has been made to assess the adrenal cortical functions in leprosy patients, especially in LL cases and also in patients with type I and type II lepra reaction by estimating serum cortisol levels in them and comparing these results with those in healthy adults. Both the patient and control population belonged to a copper mining district in an eastern state of India. Eightly leprosy patients including 23 LL, 17 BL, 3 BB, 7 BT and 30 patients with type I (10 cases) and type II (20 cases) lepra reactions formed the basis of this study. Forty-one age-matched normal adults from similar socio-economic status served as controls. The mean basal serum cortisol levels in 23 LL cases and 41 controls were 18.21 and 12.98 μg/dl, respectively. Diurnal variation of serum cortisol level was studied in 4 LL cases who showed normal circadian rhythm. Intramuscular injection of ACTH in another 4 patients (2 LL and 2 BL) showed an increase of mean serum cortisol level from 14.75 μg/dl to 21.75 μg/dl after 30 min of challenge. Most interestingly, it was found that at the onset of type II lepra reaction the mean serum cortisol level increased to 17.35 μg/dl and after remission of ENL its level decreased to 11.41 μg/dl. The difference was statistically significant (P<0.01). On the contrary, no such variation was found in patients with type I reaction.