Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report

Delwar Hossain

doi:doi:10.11648/j.ajcem.20140206.20

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Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report

Delwar Hossain

Published in American Journal of Clinical and Experimental Medicine (Volume 2, Issue 6)

Received: 8 December 2014 Accepted: 17 December 2014 Published: 22 December 2014

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Abstract

Patients may have prolonged neuritic episode in the field of leprosy. In that case, one or few interrupted courses of prednisolone of 4-months duration may prove inadequate for the unduly suffering patients. With an intention to see whether a prolonged course of prednisolone and methotrexate could be of any help for them, a patient having neuritis in several nerves including multiple abscesses in the right sural nerve was treated with a 15 months extended and continuous course of prednisolone and methotrexate. The outcome was complete and permanent remission with full functional recovery. Few mild self-limiting side effects from prednisolone were seen. However, there was no side effect from methotrexate. In conclusion, extended and continuous course of prednisolone and methotrexate was found safe and effective in treating a case of chronic neuritis.

Published in	American Journal of Clinical and Experimental Medicine (Volume 2, Issue 6)
DOI	10.11648/j.ajcem.20140206.20
Page(s)	171-174
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Leprosy, Chronic neuritis, Treatment, Prednisolone, Methotrexate

References

[1]	Job CK. Nerve damage in reversal reaction. Ind J Lepr, 1996; 68: 43-47.
[2]	Kar BR, Babu R. Methotrexate in resistant ENL. Int J Lepr Other Mycobact Dis, 2004; 72: 4: 480-82.
[3]	Delwar Hossain. Using methotrexate to treat patients with ENL unresponsive to steroid and clofazimine: A report on 9 patients. Lepr Rev, March, 2013; 84 (1): 105-112.
[4]	Stephen L. Walker and Diana N. J. Lockwood. Leprosy type 1 (reversal) reactions and their management. Lepr Rev, 2008; 79: 372-386.
[5]	Rose P, Waters MFR. Reversal reaction in leprosy and their management. Lepr Rev, 1991; 62: 113-21.
[6]	Einar P Wilder-Smith and Wim H Van Brakel. Nerve damage in leprosy and its management. Nature Clinical Practice, 2008; 4: 656-663.
[7]	David M. Scollard. The biology of nerve injury in leprosy. Lepr Rev, 2008; 79: 242-253.
[8]	Naafs B. Treatment of reactions and nerve damage. Int J Lepr, 1996; 64: S21-28.
[9]	Swierkot J, Szechinski J. Methotrexate in rheumatoid arthritis. Pharmacol Rep, 2006; 58: 473-92.
[10]	Onwukwe MF. Treating keloids by surgery and methotrexate. Arch Dermatol, 1980; 116: 158.

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APA Style

Delwar Hossain. (2014). Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report. American Journal of Clinical and Experimental Medicine, 2(6), 171-174. https://doi.org/10.11648/j.ajcem.20140206.20

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ACS Style

Delwar Hossain. Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report. Am. J. Clin. Exp. Med. 2014, 2(6), 171-174. doi: 10.11648/j.ajcem.20140206.20

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AMA Style

Delwar Hossain. Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report. Am J Clin Exp Med. 2014;2(6):171-174. doi: 10.11648/j.ajcem.20140206.20

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@article{10.11648/j.ajcem.20140206.20,
  author = {Delwar Hossain},
  title = {Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {2},
  number = {6},
  pages = {171-174},
  doi = {10.11648/j.ajcem.20140206.20},
  url = {https://doi.org/10.11648/j.ajcem.20140206.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20140206.20},
  abstract = {Patients may have prolonged neuritic episode in the field of leprosy. In that case, one or few interrupted courses of prednisolone of 4-months duration may prove inadequate for the unduly suffering patients. With an intention to see whether a prolonged course of prednisolone and methotrexate could be of any help for them, a patient having neuritis in several nerves including multiple abscesses in the right sural nerve was treated with a 15 months extended and continuous course of prednisolone and methotrexate. The outcome was complete and permanent remission with full functional recovery. Few mild self-limiting side effects from prednisolone were seen. However, there was no side effect from methotrexate. In conclusion, extended and continuous course of prednisolone and methotrexate was found safe and effective in treating a case of chronic neuritis.},
 year = {2014}
}

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TY  - JOUR
T1  - Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report
AU  - Delwar Hossain
Y1  - 2014/12/22
PY  - 2014
N1  - https://doi.org/10.11648/j.ajcem.20140206.20
DO  - 10.11648/j.ajcem.20140206.20
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 171
EP  - 174
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20140206.20
AB  - Patients may have prolonged neuritic episode in the field of leprosy. In that case, one or few interrupted courses of prednisolone of 4-months duration may prove inadequate for the unduly suffering patients. With an intention to see whether a prolonged course of prednisolone and methotrexate could be of any help for them, a patient having neuritis in several nerves including multiple abscesses in the right sural nerve was treated with a 15 months extended and continuous course of prednisolone and methotrexate. The outcome was complete and permanent remission with full functional recovery. Few mild self-limiting side effects from prednisolone were seen. However, there was no side effect from methotrexate. In conclusion, extended and continuous course of prednisolone and methotrexate was found safe and effective in treating a case of chronic neuritis.
VL  - 2
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Author Information

Delwar Hossain

Department of Dermatology and Venereology, University of Science and Technology Chittagong (USTC), Chittagong, Bangladesh

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APA Style

Delwar Hossain. (2014). Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report. American Journal of Clinical and Experimental Medicine, 2(6), 171-174. https://doi.org/10.11648/j.ajcem.20140206.20

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ACS Style

Delwar Hossain. Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report. Am. J. Clin. Exp. Med. 2014, 2(6), 171-174. doi: 10.11648/j.ajcem.20140206.20

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AMA Style

Delwar Hossain. Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report. Am J Clin Exp Med. 2014;2(6):171-174. doi: 10.11648/j.ajcem.20140206.20

Copy | Download

@article{10.11648/j.ajcem.20140206.20,
  author = {Delwar Hossain},
  title = {Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report},
  journal = {American Journal of Clinical and Experimental Medicine},
  volume = {2},
  number = {6},
  pages = {171-174},
  doi = {10.11648/j.ajcem.20140206.20},
  url = {https://doi.org/10.11648/j.ajcem.20140206.20},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajcem.20140206.20},
  abstract = {Patients may have prolonged neuritic episode in the field of leprosy. In that case, one or few interrupted courses of prednisolone of 4-months duration may prove inadequate for the unduly suffering patients. With an intention to see whether a prolonged course of prednisolone and methotrexate could be of any help for them, a patient having neuritis in several nerves including multiple abscesses in the right sural nerve was treated with a 15 months extended and continuous course of prednisolone and methotrexate. The outcome was complete and permanent remission with full functional recovery. Few mild self-limiting side effects from prednisolone were seen. However, there was no side effect from methotrexate. In conclusion, extended and continuous course of prednisolone and methotrexate was found safe and effective in treating a case of chronic neuritis.},
 year = {2014}
}

Copy | Download

TY  - JOUR
T1  - Management of Chronic Neuritis with an Extended and Continuous Course of Prednisolone and Methotrexate: A Case Report
AU  - Delwar Hossain
Y1  - 2014/12/22
PY  - 2014
N1  - https://doi.org/10.11648/j.ajcem.20140206.20
DO  - 10.11648/j.ajcem.20140206.20
T2  - American Journal of Clinical and Experimental Medicine
JF  - American Journal of Clinical and Experimental Medicine
JO  - American Journal of Clinical and Experimental Medicine
SP  - 171
EP  - 174
PB  - Science Publishing Group
SN  - 2330-8133
UR  - https://doi.org/10.11648/j.ajcem.20140206.20
AB  - Patients may have prolonged neuritic episode in the field of leprosy. In that case, one or few interrupted courses of prednisolone of 4-months duration may prove inadequate for the unduly suffering patients. With an intention to see whether a prolonged course of prednisolone and methotrexate could be of any help for them, a patient having neuritis in several nerves including multiple abscesses in the right sural nerve was treated with a 15 months extended and continuous course of prednisolone and methotrexate. The outcome was complete and permanent remission with full functional recovery. Few mild self-limiting side effects from prednisolone were seen. However, there was no side effect from methotrexate. In conclusion, extended and continuous course of prednisolone and methotrexate was found safe and effective in treating a case of chronic neuritis.
VL  - 2
IS  - 6
ER  -

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