Leprosy
mailing list – May 8th, 2005
Ccn: all.
Ref.:
alternative treatment of recurrent ENL.
From:
B Naafs
, Munnekeburen, The Netherlands.
Dear Salvatore,
Concerning the question of Dr
Dhakal, LML April 22nd.
I think it was 2 years ago
that we had an extensive discussion on severe and recurrent ENL on
this mailing list. I suggest you sent those messages to Dr Dhakal.
I may have a suggestion for an
alternative drug. It is recently published by Kar and Babu from
Karagiri (Int. J. Lepr. 2004: 72; 480-2) that methotrexate (MTX) was
of help.
A 6 years ago, before I went
to treat with high and short doses of steroids (pulse therapy) I used
in desperation also MTX in a patient and that patient responded and
did not get a new ENL after a few months of decreasing maintenance
therapy. I was not sure whether I could attribute this to the MTX
since ENL is basically a self limiting disease, so I never mentioned
it. And here in the
Netherlands
I have too few patients to do a controlled trial.
When anyone uses it, please
convey the results on this website (LML). Failures are even more
important than successes especially when no controlled trials have
been done.
Many greetings,
Ben
