Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects.
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,...
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ftdoajarticles:oai:doaj.org/article:c662d0ab09d44fb4b725ff2ac05cde21 2023-05-15T15:10:41+02:00 Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects. Diogo Fernandes Dos Santos Matheus Rocha Mendonça Douglas Eulálio Antunes Elaine Fávaro Pípi Sabino Raquel Campos Pereira Luiz Ricardo Goulart Isabela Maria Bernardes Goulart 2017-11-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0006086 https://doaj.org/article/c662d0ab09d44fb4b725ff2ac05cde21 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5720806?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006086 https://doaj.org/article/c662d0ab09d44fb4b725ff2ac05cde21 PLoS Neglected Tropical Diseases, Vol 11, Iss 11, p e0006086 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0006086 2022-12-31T03:38:08Z 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.Seventy patients diagnosed with primary neural leprosy from 2014 to 2016 underwent clinical, laboratorial and neurophysiological evaluation. All patients presented an asymmetric neural impairment, with nerve thickening in 58.6%. Electroneuromyography showed a pattern of mononeuropathy in 51.4%. Positivity for ELISA anti-PGL1 was 52.9%, while the qPCR of slit skin smear was 78.6%. The qPCR of nerve biopsies was positive in 60.8%. Patients with multiple mononeuropathy patterns showed lower levels of anti-PGL-1 (p = 0.0006), and higher frequency of neural thickening (p = 0.0008) and sensory symptoms (p = 0.01) than those with mononeuropathy.PNL is not a synonym of pure neural leprosy, as this condition may include a generalized immune response and also a skin involvement, documented by molecular findings. Immunological, molecular, and neurophysiological tools must be implemented for diagnosing primary neural leprosy to achieve effective treatment and reduction of its resultant disabilities that still represent a public health problem in several developing nations. Finally, we propose a algorithm and recommendations for the diagnosis of primary neural leprosy based on the combination of the three clinical-laboratorial tools. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 11 e0006086 |
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Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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English |
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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 Diogo Fernandes Dos Santos Matheus Rocha Mendonça Douglas Eulálio Antunes Elaine Fávaro Pípi Sabino Raquel Campos Pereira Luiz Ricardo Goulart Isabela Maria Bernardes Goulart Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects. |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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.Seventy patients diagnosed with primary neural leprosy from 2014 to 2016 underwent clinical, laboratorial and neurophysiological evaluation. All patients presented an asymmetric neural impairment, with nerve thickening in 58.6%. Electroneuromyography showed a pattern of mononeuropathy in 51.4%. Positivity for ELISA anti-PGL1 was 52.9%, while the qPCR of slit skin smear was 78.6%. The qPCR of nerve biopsies was positive in 60.8%. Patients with multiple mononeuropathy patterns showed lower levels of anti-PGL-1 (p = 0.0006), and higher frequency of neural thickening (p = 0.0008) and sensory symptoms (p = 0.01) than those with mononeuropathy.PNL is not a synonym of pure neural leprosy, as this condition may include a generalized immune response and also a skin involvement, documented by molecular findings. Immunological, molecular, and neurophysiological tools must be implemented for diagnosing primary neural leprosy to achieve effective treatment and reduction of its resultant disabilities that still represent a public health problem in several developing nations. Finally, we propose a algorithm and recommendations for the diagnosis of primary neural leprosy based on the combination of the three clinical-laboratorial tools. |
format |
Article in Journal/Newspaper |
author |
Diogo Fernandes Dos Santos Matheus Rocha Mendonça Douglas Eulálio Antunes Elaine Fávaro Pípi Sabino Raquel Campos Pereira Luiz Ricardo Goulart Isabela Maria Bernardes Goulart |
author_facet |
Diogo Fernandes Dos Santos Matheus Rocha Mendonça Douglas Eulálio Antunes Elaine Fávaro Pípi Sabino Raquel Campos Pereira Luiz Ricardo Goulart Isabela Maria Bernardes Goulart |
author_sort |
Diogo Fernandes Dos Santos |
title |
Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects. |
title_short |
Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects. |
title_full |
Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects. |
title_fullStr |
Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects. |
title_full_unstemmed |
Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects. |
title_sort |
revisiting primary neural leprosy: clinical, serological, molecular, and neurophysiological aspects. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0006086 https://doaj.org/article/c662d0ab09d44fb4b725ff2ac05cde21 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 11, p e0006086 (2017) |
op_relation |
http://europepmc.org/articles/PMC5720806?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0006086 https://doaj.org/article/c662d0ab09d44fb4b725ff2ac05cde21 |
op_doi |
https://doi.org/10.1371/journal.pntd.0006086 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
11 |
container_issue |
11 |
container_start_page |
e0006086 |
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