One patient, two diseases
Artur was admitted to the Hospital Colónia Rovisco Pais in 1957, was 58 years old, single and lived alone, and on what he cultivated. Born and resident in Fafe, he was identified by a Medical Brigade. His health status was worrying from what is described. In 1964 his clinical case was published in Revista Rovisco Pais.
After the screening, exams of the nasal mucus and skin were positive. The lepromino-reaction – Mitsuda was negative and the histological diagnosis was compatible with lepromatous leprosy.
It was not possible to ascertain the source of contagion or ascertain the existence of family history. Since he was young, he had kyphoscoliosis and small, soft nodules hanging from the forehead, neck, chest, back, buttocks and legs, and for about 18 years he suffered from stomach pains, nausea and vomiting. In addition to these data, at the date of admission, signs of erythematous infiltration on the face and forehead and different nodules were visible.
During his hospitalization, he had several outbreaks of nodular erythema-like leprosy reaction, with high fever, neuralgia of the limbs, osteo-articular pain and worsening of gastric symptoms.Radiological exams revealed sequelae of gastric ulcer and duodenitis.
Os exames radiológicos revelaram sequela de úlcera gástrica e duodenite.
After two years of drug therapy, smear microscopy was negative and remained positive on the skin, with clusters of leprosy bacilli, called globias, so he remained in the hospital.
However, his complaints and the global condition worsened, with headaches and stomach intolerance to food, even liquids, convulsions, physical depletion, being prostrated in bed, drowsiness.
The analysis spectrum was broadened and in addition to the diagnosis of leprosy disease, it was found to be a patient with cutaneous neurofibroma.
The persistence of symptoms ends up making a tumor in the central nervous system or gastric neoplasia suspicious. Due to its clinical condition, it was possible to perform a skull X-ray in October 1963, which reinforced the hypothesis of a brain tumor.
The patient died in January 1964. The biopsy performed in the hospital and analyzed in the laboratory would eventually reveal an aggressive malignant tumor of the glioblastioma type in the brain.
In addition to lepromatous leprosy, he suffered from von Recklinghausen’s disease, a genetic disease that affects the skin and the neurological system.
(Based on documents from the HCRP Archive. Research and writing by Cristina Nogueira – CulturAge)
