Pathology and pathogenesis of leprous neuritis; a preventable and treatable complication.
In conclusion, it may be said that many advances have been made in the diagnosis, treatment and prevention of nerve damage. It is now a well accepted fact that the affinity of M. leprae for Schwann cells and the property of M. leprae to grow in cooler sites of the body have made certain segments of nerve trunks vulnerable. Trauma that supervenes the inflammation and swelling severely aggravates the nerve damage. The reactive phase in all forms of leprosy, the etiology of which is not clearly understood, produces intraneural caseous necrosis in tuberculoid disease and microabscesses in lepromatous disease, causing much irreversible damage to nerves. The steroid treatment that is administered during the reactive phase has helped greatly to stop further damage, although the damage already done to nerves is not always reversible. Preventive measures like detecting the disease before nerve trunks are infected and offering prompt and adequate antileprosy therapy as early as possible have helped to reduce the prevalence of deformities. It is hoped that administering steroids along with antileprosy therapy to prevent active inflammation and or fibrosis of the nerve will reduce the prevalence of nerve damage significantly. Measures which provide rest for the infected nerve to prevent trauma should be explored.
Job
C K
CK
St. Thomas Hospital and Leprosy Centre, Chettupattu 606 801, T.V. Malai District, Tamil Nadu, India.
D006801:Humans; D007918:Leprosy / Q000150:complications*; D009166:Mycobacterium leprae / Q000302:isolation & purification; D009443:Neuritis / Q000382:microbiology / Q000473:pathology / Q000503:physiopathology / Q000517:prevention & control; D010525:Peripheral Nerves / Q000382:microbiology / Q000473:pathology