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MCQs in Tropical Medicine

Rob Skelly DTM+H FRCP

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Answer 71

Thalidomide is used in the treatment of
False a. HIV-associated peripheral neuropathy
False b. hyperemesis gravidarum
True c. erythema nodosum leprosum
True d. Behcet's disease
True e. HIV-associated mouth ulcers


This drug was used in the 1960's to treat hyperemesis gravidarum and is notorious for its association with phocomelia. It should never be used in pregnancy. It is an anti-inflammatory, immunomodulant drug which acts by interfering with phagocyte migration and TNF-alpha secretion. It has no direct effect on lymphocytes and does not inhibit HIV replication. It is beneficial in HIV-associated mouth ulcers and may have a role in HIV-associated cachexia. It is also beneficial in mucocutaneous ulceration not associated with HIV. Other conditions reported to respond to thalidomide include: discoid lupus erythematosus, erythema multiforme, ulcerative colitis, rheumatoid arthritis and chronic graft-versus-host disease. The incidence of side effects is high, mainly peripheral neuropathy. It has no product licence in the UK. For these reasons its use should be restricted: it should probably only be used when other appropriate drugs have been tried but have failed.

Copyright: Rob Skelly 2006