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논문분류	춘계학술대회 초록집
제목	A Case Report of Chronic Kidney Disease Patient and Morbus Hansen with Second Degree Disability
저자	Asticha Erlianing Sari
출판정보	2024; 2024(1):
키워드
초록	Morbus hansen is a chronic infectious disease caused by Mycobacterium leprae which can attack the peripheral nerves, skin and other organs such as kidney. Although M. leprae does not ordinarily invade the renal parenchyma, renal abnormalities in leprosy have been described in previous study. A 49-year-old man was presented to Dr. Moewardi Hospital with complaints of black tarry stool since 1 week before admission with stable vital sign. The patient also complained about foot ulcers in both legs that were numb and painless since 5 years ago. The patient had history of morbus hansen and completely treated with multibacillary multidrug therapy. On physical examination, we found pale conjunctiva, contracture in both hands, no palpable peripheral nerves, large ulcers on the plantar pedis and muscle atrophy accompanied by anesthesia of both hands and legs. Laboratory tests entailed: hemoglobin 3.8 g/dl, creatinine 5.8 mg/dl, ureum 294 mg/dl, sodium level 128 mmol/L, potassium level 6.8 mmol/L, normal liver function tests, and proteinuria. Small and echogenic kidneys were found on ultrasound imaging. On bacterioscopic examination, BTA was negative. On histopathological examination with hematoxylin and eosin staining, epithelioid cells affecting the epidermis, increasing histiocytes, no lymphocytes, and no giant Langhans cells were found. We confirmed it with fite faraco staining, BTA was also negative. Ulcer peptic was found on upper GI endoscopy. The patient was treated initially by PPI, blood transfusion, and hemodialysis. Uremia represents a late complication of leprosy and has a multifactorial genesis. Kidney biopsy needs to be performed to confirm the diagnosis although we have limitations to do so. More studies are needed to determine whether morbus hansen has higher risk to become chronic kidney disease in the future and what measures should be taken to reduce the risk of chronic kidney disease among patients who have morbus hansen.
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