The two extremes of Hansen's disease-Different manifestations of leprosy and their biological consequences in an Avar Age (late 7th century CE) osteoarchaeological series of the Duna-Tisza Interfluve (Kiskundorozsma-Daruhalom-dűlő II, Hungary)

PLoS One. 2022 Jun 23;17(6):e0265416. doi: 10.1371/journal.pone.0265416. eCollection 2022.

Abstract

To give an insight into the different manifestations of leprosy and their biological consequences in the Avar Age of the Hungarian Duna-Tisza Interfluve, two cases from the 7th-century-CE osteoarchaeological series of Kiskundorozsma-Daruhalom-dűlő II (Hungary; n = 94) were investigated. Based on the macromorphology of the bony changes indicative of Hansen's disease, KD271 (a middle-aged male) and KD520 (a middle-aged female) represent the two extremes of leprosy. KD271 appears to have an advanced-stage, long-standing near-lepromatous or lepromatous form of the disease, affecting not only the rhinomaxillary region but also both upper and lower limbs. This has led to severe deformation and disfigurement of the involved anatomical areas of the skeleton, resulting in his inability to perform the basic activities of daily living, such as eating, drinking, grasping, standing or walking. The skeleton of KD520 shows no rhinomaxillary lesions and indicates the other extreme of leprosy, a near-tuberculoid or tuberculoid form of the disease. As in KD271, Hansen's disease has resulted in disfigurement and disability of both of the lower limbs of KD520; and thus, the middle-aged female would have experienced difficulties in standing, walking, and conducting occupational physical activities. KD271 and KD520 are amongst the very few published cases with leprosy from the Avar Age of the Hungarian Duna-Tisza Interfluve, and the only examples with detailed macromorphological description and differential diagnoses of the observed leprous bony changes. The cases of these two severely disabled individuals, especially of KD271 -who would have required regular and substantial care from others to survive-imply that in the Avar Age community of Kiskundorozsma-Daruhalom-dűlő II there was a willingness to care for people in need.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living*
  • Benzodiazepines
  • Diagnosis, Differential
  • Female
  • Humans
  • Hungary
  • Leprosy* / diagnosis
  • Male
  • Middle Aged
  • Sulfur

Substances

  • Benzodiazepines
  • pinazepam
  • Sulfur

Grants and funding

This work was supported by the University of Szeged Open Access Fund (grant number 5352) to OS. The National Research, Development and Innovation Office (Hungary) (grant number K 125561) and the "Árpád-ház Program" (grant number 39509/2018/KFSZ) of the Hungarian Ministry of Human Capacities provided funding for GP. This project received funding from the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation programme (grant number 856453 ERC-2019-SyG) to TV. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.