Vasculitic neuropathy in a patient with inactive treated lepromatous leprosy.
A 46 year old Asian male with previously treated lepromatous leprosy developed a stepwise multifocal sensory disturbance 25 years later. Neurophysiology demonstrated marked deterioration from previous studies. Sural nerve biopsy disclosed a vasculitic process superimposed on inactive lepromatous leprosy. Immunocytochemical stains for mycobacterial antigen showed deposits within nerve and vessel walls. A delayed vasculitic neuropathy precipitated by persisting mycobacterial antigen is proposed.
Bowen
J R
JR
Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK.
McDougall
A C
AC
Morris
J H
JH
Lucas
S B
SB
Donaghy
M
M
D004576:Electromyography; D006801:Humans; D015440:Leprosy, Lepromatous / Q000150:complications* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010525:Peripheral Nerves / Q000473:pathology / Q000503:physiopathology; D010523:Peripheral Nervous System Diseases / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology; D014657:Vasculitis / Q000150:complications* / Q000473:pathology* / Q000503:physiopathology