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neural leprosy

Diogo Fernandes Dos Santos, Matheus Rocha Mendonça, Douglas Eulálio Antunes, Elaine Fávaro Pípi Sabino, Raquel Campos Pereira, Luiz Ricardo Goulart, Isabela Maria Bernardes Goulart
BACKGROUND: Household contacts constitute the highest risk group for leprosy development, and despite significant progress in the disease control, early diagnosis remains the primary goals for leprosy management programs. METHODS: We have recruited 175 seropositive and 35 seronegative household contacts from 2014 to 2016, who were subjected to an extensive protocol that included clinical, molecular (peripheral blood qPCR, slit-skin smear qPCR, skin biopsy qPCR) and electroneuromyographic evaluations...
May 21, 2018: PLoS Neglected Tropical Diseases
Xiaohua Chen, Liangfu Zhang, Meiying Huang, Xiuli Zhai, Yan Wen, Chunzhi Pan
The purpose of this study was to evaluate peripheral neural impairment in leprosy patients by ultrasonography (US). The cross-sectional areas (CSAs) of the median (M), ulnar (U) and common fibular (CF) nerves were compared in 71 leprosy patients and 29 healthy controls, and the data were analyzed between the leprosy, multibacillary (MB)/paucibacillary (PB), reaction (R)/no reaction (NR), disability (D)/no disability (ND), and longer/shorter duration groups after treatment. We found that for the nerves located in upper limbs, the CSAs were significantly increased in the leprosy patients vs the controls; the PB group vs the MB group; the R group vs the NR group; the ND group vs the D group; and the longer duration group vs the shorter duration group at some positions of the M nerve and U nerve...
May 17, 2018: Scientific Reports
Louise Mara Giesel, Izabela Jardim Rodrigues Pitta, Raquel Custódio Silveira, Lígia Rocha Andrade, Robson Teixeira Vital, José Augusto da Costa Nery, Mariana de Andrea Vilas Boas Hacker, Euzenir Nunes Sarno, Marcia Maria Jardim Jardin
Neural pain is a frequent symptom in leprosy disease. There is a paucity of data regarding neural pain diagnostics resulting in common prescriptive errors when neuritis is confused with neuropathic or mixed nociceptive-neuropathic pain. The present study identified important demographic, clinical, and neurophysiological features of 42 leprosy neuropathy patients presenting neuropathic pain (NP). During routine evaluations, patients were selected asking if they had ever experienced neural pain. Data analyses of their pain characteristics, clinical examination results, and both the Douleur Neuropathique 4 Questionnaire and Hamilton Depression Scale scores were used to classify these patients...
April 2, 2018: American Journal of Tropical Medicine and Hygiene
Vishal Gupta, Tanvi Dev, Chandan J Das, Neena Khanna
A 34-year-old Indian man presented to an orthopaedician with gradually progressive hypoesthesia affecting his right lower limb and an ipsilateral common peroneal nerve swelling around the knee. The nerve swelling was diagnosed as a peripheral nerve sheath tumour based on MRI findings and was excised, only to be revealed as leprous nerve abscess on histopathology later. The patient developed right foot drop as a result of common peroneal nerve biopsy. This case presents several learning points in the diagnosis of pure neural leprosy...
December 5, 2017: BMJ Case Reports
Diogo Fernandes Dos Santos, Matheus Rocha Mendonça, Douglas Eulálio Antunes, Elaine Fávaro Pípi Sabino, Raquel Campos Pereira, Luiz Ricardo Goulart, Isabela Maria Bernardes Goulart
BACKGROUND: Leprosy neuropathy is considered the most common peripheral neuropathy of infectious etiology worldwide, representing a public health problem. Clinical diagnosis of primary neural leprosy (PNL) is challenging, since no skin lesions are found and the slit skin smear bacilloscopy is negative. However, there are still controversial concepts regarding the primary-neural versus pure-neural leprosy definition, which will be explored by using multiple clinical-laboratory analyses in this study...
November 2017: PLoS Neglected Tropical Diseases
Fabiane Leonel Utino, Gislaine Vieira Damiani, Marina Garcia, Tânia Cristina Benetti Soares, Rafael Fantelli Stelini, Paulo Eduardo Neves Ferreira Velho, Elemir Macedo de Souza, Maria Letícia Cintra
BACKGROUND: More than 200 000 new cases of leprosy are detected worldwide annually. Physicians commonly have difficulty in differentiating tuberculoid form of leprosy (TL) from sarcoidosis' cutaneous manifestation. METHODS: Skin biopsies of 33 patients with TL and 24 with sarcoidosis were reviewed on hematoxylin and eosin- and Gomori-stained sections, in order to find reliable criteria for distinguishing one disease from another. RESULTS: Nine of the 24 features analyzed presented significant predictive value for diagnosis (P < ...
February 2018: Journal of Cutaneous Pathology
Song-Hyo Jin, Sung-Kwan An, Seong-Beom Lee
Leprosy is a chronic infectious disease that is caused by the obligate intracellular pathogen Mycobacterium leprae (M.leprae), which is the leading cause of all non-traumatic peripheral neuropathies worldwide. Although both myelinating and non-myelinating Schwann cells are infected by M.leprae in patients with lepromatous leprosy, M.leprae preferentially invades the non-myelinating Schwann cells. However, the effect of M.leprae infection on non-myelinating Schwann cells has not been elucidated. Lipid droplets (LDs) are found in M...
June 2017: PLoS Neglected Tropical Diseases
R Dhakhwa, S Acharya, S Pradhan, S B Shrestha, T Itoh
INTRODUCTION: Histopathologic diagnosis of leprosy is difficult when Bacillary Index (BI) is zero and neural involvement are not easily identifiable on routine Hematoxylin and Eosin stain. This study was undertaken to study the role of S-100 immunostaining in demonstrating different patterns of nerve involvement in various types of leprosy. METHODS: Thirty one skin biopsies with clinico-histopathologic diagnoses of leprosy over a period of two years were included in the study...
January 2017: JNMA; Journal of the Nepal Medical Association
Muhammed Afsal, Veena Chowdhury, Anjali Prakash, Sapna Singh, Neera Chowdhury
PURPOSE: Traditionally, peripheral nerve lesions are diagnosed on the basis of clinical history, physical examination, and electrophysiological studies, and the role of imaging studies has been limited. The purpose of the study was to assess the usefulness of sonography in diagnosing peripheral nerve lesions. MATERIALS AND METHODS: Thirty adult patients with peripheral nerve lesion/s and 30 healthy adult volunteers were included in the study, and sonography of the relevant peripheral nerve/s was done...
September 2016: Neurology India
J M Pardal-Fernandez, S Ezsol-Lendvai, M Rodriguez-Vazquez, J L Agudo-Mena, B Godes-Medrano
INTRODUCTION: Leprosy is an infectious disease caused by the bacteria Mycobacterium leprae. It is particularly prone to affect the skin and the nerve trunks and, in fact, both are compromised in most infected patients. It is transmitted by exposure to those with the disease and sometimes by reactivation. One uncommon possibility is pure neural leprosy, which is characterised by neuropathy, but without skin lesions. We report the case of a patient with pure neural leprosy and review the diagnostic aspects...
September 16, 2016: Revista de Neurologia
Rychelle Clayde Affonso Medeiros, Karina do Carmo de Vasconcelos Girardi, Fernanda Karlla Luz Cardoso, Bruno de Siqueira Mietto, Thiago Gomes de Toledo Pinto, Lilian Sales Gomez, Luciana Silva Rodrigues, Mariana Gandini, Julio Jablonski Amaral, Sérgio Luiz Gomes Antunes, Suzana Corte-Real, Patricia Sammarco Rosa, Maria Cristina Vidal Pessolani, José Augusto da Costa Nery, Euzenir Nunes Sarno, Leonardo Ribeiro Batista-Silva, Mauro Sola-Penna, Marcus Fernandes Oliveira, Milton Ozório Moraes, Flavio Alves Lara
Mycobacterium leprae, the intracellular etiological agent of leprosy, infects Schwann promoting irreversible physical disabilities and deformities. These cells are responsible for myelination and maintenance of axonal energy metabolism through export of metabolites, such as lactate and pyruvate. In the present work, we observed that infected Schwann cells increase glucose uptake with a concomitant increase in glucose-6-phosphate dehydrogenase (G6PDH) activity, the key enzyme of the oxidative pentose pathway...
October 7, 2016: Journal of Biological Chemistry
Xiaoshuai Zhang, Zhongshang Yuan, Jiadong Ji, Hongkai Li, Fuzhong Xue
BACKGROUND: In stark contrast to network-centric view for complex disease, regression-based methods are preferred in disease prediction, especially for epidemiologists and clinical professionals. It remains a controversy whether the network-based methods have advantageous performance than regression-based methods, and to what extent do they outperform. METHODS: Simulations under different scenarios (the input variables are independent or in network relationship) as well as an application were conducted to assess the prediction performance of four typical methods including Bayesian network, neural network, logistic regression and regression splines...
August 18, 2016: BMC Medical Research Methodology
Pedro Olavo De Paula Lima, Francisco Marcos Bezerra Cunha, Heitor De Sá Gonçalves, Maria Araci Pontes Aires, Rosa Lívia Freitas De Almeida, Ligia Regina Franco Sansigolo Kerr
BACKGROUND: In leprosy, sensory function of nerves is evaluated with monofilaments test and the motor function with voluntary muscle test, however electroneuromyography is considered as the gold-standard tool. OBJECTIVES: This study aimed: i) to evaluate the correlation between clinical tests and electroneuromyography for the diagnosis of leprosy neuropathy; and ii) to identify the prevalence of leprosy neuropathy and the most compromised peripheral nerves in leprosy...
March 2016: Leprosy Review
Carlos Gustavo Wambier, Sarah Perillo de Farias Wambier, Renata Bazan Furini, João Carlos Lopes Simão, Marco Andrey Cipriani Frade, Norma Tiraboschi Foss
INTRODUCTION: Leprosy is mainly transmitted among family members who share genetic and ambient factors. The clinical form of leprosy in the index case and kinship could be risk factors for leprosy transmission. High antibody levels in household contacts (HC) in the absence of neural or skin lesions may characterize latent infection. This study aimed to evaluate the association between seropositivity for anti-phenolic glycolipid-I immunoglobulin M antibodies (APGL-I) in HC and the clinical classification of the index case and to analyze the association between APGL-I positivity with other factors such as age, kinship, and gender...
February 2016: Revista da Sociedade Brasileira de Medicina Tropical
Tatiane Aparecida Queiroz, Francisca Patrícia Barreto de Carvalho, Clélia Albino Simpson, Amélia Carolina Lopes Fernandes, Débora Lúcia de Araújo Figueirêdo, Maria Irany Knackfuss
OBJECTIVE: To identify the clinical and epidemiological profile of patients under treatment for leprosy-related reactions. METHOD: This is a descriptive, cross-sectional and quantitative study, conducted from October 2013 to April 2014 with 61 individuals in a reference center in the Brazilian northeast region. The statistical test used considered a significance level of 0,05. RESULTS: Most individuals were males (57.38%), with low family income (50...
2015: Revista Gaúcha de Enfermagem
G Sahay, H K Kar, R Gupta
The effects of corticosteroids in varying doses and duration for the treatment of reaction and nerve function impairment (NFI) in leprosy have been studied extensively. However, an optimal dose and duration of steroid when used as a prophylactic agent for NFI is yet to be established. This study was aimed to determine whether addition of low dose steroid for the initial 8 months of multi drug therapy (MDT) can prevent further deterioration of nerve function (DON) in multibacillary leprosy patients. Sixty multibacillary leprosy patients were randomized into two groups and B consisting of 30 patients each...
July 2015: Indian Journal of Leprosy
Yvelise T Morato-Conceicao, Eduardo R Alves-Junior, Talita A Arruda, Jose C Lopes, Cor J F Fontes
Background. Leprosy reactions are acute inflammatory episodes that occur mainly in the multibacillary forms of the disease. The reactions are classified as type 1 (reverse reaction) or type 2 (erythema nodosum leprosum). Leprosy-associated oxidative stress has been widely demonstrated. Several recent studies have shown uric acid (UA) to have antioxidative effects under pathologic conditions. The objective of this study was to assess serum levels of UA in patients with leprosy reactions, with the aim of monitoring their levels before and after treatment, compared with levels in leprosy patients without reactions...
2016: PeerJ
Ismael Alves Rodrigues Júnior, Letícia Trivellato Gresta, Maria de Lourdes Meirelles Noviello, Christiane Teixeira Cartelle, Sandra Lyon, Rosa Maria Esteves Arantes
OBJECTIVES: Different methods for the classification of leprosy have been proposed since the 1930s. The aim of this study was to compare the current methods at a referral center in Brazil. METHODS: The World Health Organization (WHO) operational classification was compared to the Ridley and Jopling classification, the Madrid classification, and a classification based on the number of body areas affected by skin and/or neural lesions (NBAA). The correlation between the clinical and histopathological components of the Ridley and Jopling classification was assessed...
April 2016: International Journal of Infectious Diseases: IJID
Maria Angela Bianconcini Trindade, Lana Luiza da Cruz Silva, Lucia Maria Almeida Braz, Valdir Sabbaga Amato, Bernard Naafs, Mirian Nacagami Sotto
BACKGROUND: Post-kala-azar dermal leishmaniasis (PKDL) is a dermal complication of visceral leishmaniasis (VL), which may occur after or during treatment. It has been frequently reported from India and the Sudan, but its occurrence in South America has been rarely reported. It may mimic leprosy and its differentiation may be difficult, since both diseases may show hypo-pigmented macular lesions as clinical presentation and neural involvement in histopathological investigations. The co-infection of leprosy and VL has been reported in countries where both diseases are endemic...
2015: BMC Infectious Diseases
K D Barman, A Madan, V K Garg, K Goel, N Khurana
Lepra reactions are acute episodes occurring during the disease process of leprosy and are of 2 types: type 1 or reversal reaction and type 2 reaction or erythema odosumleprosum (ENL). In the episodes of lepra reaction several parts are affected including face and extremities like oral cavity. In the present case report we reported a rare case of lepromatous leprosy with necrotic ENL involving scalp apart from the usual sites. A 58 year old married male presented to us with complaints of spontaneous onset, recurrent eruption of multiple reddish raised painful lesions...
January 2015: Indian Journal of Leprosy
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