Existing literature on factors triggering leprosy reactions is based only on case reports and case series, and thus probably gives a biased view. We undertook a case-control study to investigate such purported trigger factors in 42 leprosy reaction patients and 40 non-reactional controls, and the cost of investigations required for the same. Detailed history, clinical evaluation and investigations for triggers were carried out. Infections (typhoid, dental caries) were the most common triggers found, followed by pregnancy. Trigger factors were commoner in the type 2 reaction (T2R) group compared to type 1 (T1R) reaction group. There was however no statistical difference between the two groups. The average estimated cost of investigations was higher in the reactional group and this difference was statistically significant. Hence, except for essential investigations required for initiating steroids, an extensive battery of investigations is unjustified unless the medical history suggests a definitive infective trigger.

中文翻译：

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是时候重新审视所谓的麻风反应与感染诱因的联系了：给患者带来不必要的经济负担。

现有关于麻风反应触发因素的文献仅基于病例报告和病例系列，因此可能给出有偏见的观点。我们进行了一项病例对照研究，以调查 42 名麻风反应患者和 40 名无反应对照患者中此类所谓的触发因素，以及所需的调查费用。进行了详细的病史、临床评估和触发因素调查。感染（伤寒、龋齿）是最常见的诱因，其次是怀孕。与 1 型反应 (T1R) 组相比，2 型反应 (T2R) 组的触发因素更为常见。然而两组之间没有统计学差异。反应组的平均估计调查成本较高，并且这种差异具有统计学意义。因此，除了启动类固醇所需的必要调查之外，除非病史表明存在明确的感染触发因素，否则进行广泛的调查是不合理的。