دورية أكاديمية
Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil.
| العنوان: | Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. |
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| المؤلفون: | Pitta IJR; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.; Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil., Hacker MAV; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil., Andrade LR; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.; Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil., Spitz CN; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.; Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil., Vital RT; Department of Neurology, Pedro Ernesto University Hospital/Rio de Janeiro State University, Rio de Janeiro, Brazil., Sales AM; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil., Antunes SLG; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil., Sarno EN; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil., Jardim MR; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.; Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.; Department of Neurology, Pedro Ernesto University Hospital/Rio de Janeiro State University, Rio de Janeiro, Brazil. |
| المصدر: | PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2022 Jan 11; Vol. 16 (1), pp. e0010070. Date of Electronic Publication: 2022 Jan 11 (Print Publication: 2022). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Public Library of Science Country of Publication: United States NLM ID: 101291488 Publication Model: eCollection Cited Medium: Internet ISSN: 1935-2735 (Electronic) Linking ISSN: 19352727 NLM ISO Abbreviation: PLoS Negl Trop Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: San Francisco, CA : Public Library of Science |
| مواضيع طبية MeSH: | Leprosy, Tuberculoid/*diagnosis , Leprosy, Tuberculoid/*pathology , Neural Conduction/*physiology , Polyneuropathies/*diagnosis, Brazil ; Drug Therapy, Combination ; Female ; Humans ; Leprostatic Agents/therapeutic use ; Leprosy, Tuberculoid/drug therapy ; Male ; Middle Aged ; Mycobacterium leprae/isolation & purification ; Paresthesia/pathology ; Polyneuropathies/microbiology ; Polyneuropathies/pathology |
| مستخلص: | Introduction: Pure Neural Leprosy (PNL) is a rare clinical form of leprosy in which patients do not present with the classical skin lesions but have a high burden of the disability associated with the disease. Clinical characteristics and follow up of patients in PNL are still poorly described in the literature. Objective: This paper aims to describe the clinical, electrophysiological and histopathological characteristics of PNL patients, as well as their evolution after multidrug therapy (MDT). Methods: Fifty-two PNL patients were selected. Clinical, nerve conduction studies (NCS), histopathological and anti-PGL-1serology were evaluated. Patients were also assessed monthly during the MDT. At the end of the MDT, all of the patients had a new neurological examination and 44 were submitted to another NCS. Results: Paresthesia was the complaint most frequently reported by patients, and in the neurological examination the most common pattern observed was impairment in sensory and motor examination and a mononeuropathy multiplex. Painful nerve enlargement, a classical symptom of leprosy neuropathy, was observed in a minority of patients and in the motor NCS axonal injuries, alone or in combination with demyelinating features, were the most commonly observed. 88% of the patients did not present any leprosy reaction during MDT. There was no statistically significant difference between the neurological examinations, nor the NCS pattern, performed before and after the MDT. Discussion: The classical hallmarks of leprosy neuropathy are not always present in PNL making the diagnosis even more challenging. Nerve biopsy is an important tool for PNL diagnosis as it may guide therapeutic decisions. This paper highlights unique characteristics of PNL in the spectrum of leprosy in an attempt to facilitate the diagnosis and management of these patients. Competing Interests: The authors have declared that no competing interests exist. |
| References: | Clin Neurol Neurosurg. 2015 Apr;131:5-10. (PMID: 25655301) PLoS Negl Trop Dis. 2017 Nov 27;11(11):e0006086. (PMID: 29176796) Clin Dermatol. 2016 Jan-Feb;34(1):51-8. (PMID: 26773623) Int J Lepr Other Mycobact Dis. 1991 Sep;59(3):385-91. (PMID: 1890361) Int J Lepr Other Mycobact Dis. 2004 Sep;72(3):284-90. (PMID: 15485285) Brain Behav. 2012 May;2(3):249-55. (PMID: 22741099) Muscle Nerve. 2021 Aug;64(2):125-139. (PMID: 33629393) Arq Neuropsiquiatr. 2007 Dec;65(4A):969-73. (PMID: 18094856) Int Health. 2012 Jun;4(2):77-85. (PMID: 24029146) J Neurol. 2003 Jul;250(7):806-9. (PMID: 12883921) J Neurol. 1992 Aug;239(7):367-74. (PMID: 1403017) J Peripher Nerv Syst. 2020 Jun;25(2):191-203. (PMID: 32250546) Lepr Rev. 2005 Sep;76(3):232-40. (PMID: 16248210) Int J Lepr Other Mycobact Dis. 1966 Jul-Sep;34(3):255-73. (PMID: 5950347) |
| المشرفين على المادة: | 0 (Leprostatic Agents) |
| تواريخ الأحداث: | Date Created: 20220111 Date Completed: 20220216 Latest Revision: 20220216 |
| رمز التحديث: | 20240628 |
| مُعرف محوري في PubMed: | PMC8752023 |
| DOI: | 10.1371/journal.pntd.0010070 |
| PMID: | 35015773 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1935-2735 |
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| DOI: | 10.1371/journal.pntd.0010070 |