Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil.
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...
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ftdoajarticles:oai:doaj.org/article:4e46253ea953430d93a36bfdac7a5798 2023-05-15T15:12:33+02:00 Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. Izabela Jardim Rodrigues Pitta Mariana de Andrea Vilas-Boas Hacker Ligia Rocha Andrade Clarissa Neves Spitz Robson Teixeira Vital Anna Maria Sales Sergio Luiz Gomes Antunes Euzenir Nunes Sarno Marcia Rodrigues Jardim 2022-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010070 https://doaj.org/article/4e46253ea953430d93a36bfdac7a5798 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010070 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010070 https://doaj.org/article/4e46253ea953430d93a36bfdac7a5798 PLoS Neglected Tropical Diseases, Vol 16, Iss 1, p e0010070 (2022) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2022 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010070 2022-12-31T11:06:36Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 16 1 e0010070 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Izabela Jardim Rodrigues Pitta Mariana de Andrea Vilas-Boas Hacker Ligia Rocha Andrade Clarissa Neves Spitz Robson Teixeira Vital Anna Maria Sales Sergio Luiz Gomes Antunes Euzenir Nunes Sarno Marcia Rodrigues Jardim Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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. |
format |
Article in Journal/Newspaper |
author |
Izabela Jardim Rodrigues Pitta Mariana de Andrea Vilas-Boas Hacker Ligia Rocha Andrade Clarissa Neves Spitz Robson Teixeira Vital Anna Maria Sales Sergio Luiz Gomes Antunes Euzenir Nunes Sarno Marcia Rodrigues Jardim |
author_facet |
Izabela Jardim Rodrigues Pitta Mariana de Andrea Vilas-Boas Hacker Ligia Rocha Andrade Clarissa Neves Spitz Robson Teixeira Vital Anna Maria Sales Sergio Luiz Gomes Antunes Euzenir Nunes Sarno Marcia Rodrigues Jardim |
author_sort |
Izabela Jardim Rodrigues Pitta |
title |
Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. |
title_short |
Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. |
title_full |
Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. |
title_fullStr |
Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. |
title_full_unstemmed |
Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro-Brazil. |
title_sort |
follow-up assessment of patients with pure neural leprosy in a reference center in rio de janeiro-brazil. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2022 |
url |
https://doi.org/10.1371/journal.pntd.0010070 https://doaj.org/article/4e46253ea953430d93a36bfdac7a5798 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 16, Iss 1, p e0010070 (2022) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010070 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010070 https://doaj.org/article/4e46253ea953430d93a36bfdac7a5798 |
op_doi |
https://doi.org/10.1371/journal.pntd.0010070 |
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PLOS Neglected Tropical Diseases |
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e0010070 |
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