Clinical, electroneuromyographic and morphological studies of pure neural leprosy in a Brazilian referral centre.
Nineteen patients with pure neural leprosy were analysed with clinical examination, electroneuromyography and histopathology of nerve biopsies. Clinical examination showed sensory loss (78.9%), paresis (78.9%), nerve enlargement (68.4%) and nerve pain (42.1%). Electroneuromyographic study revealed an axonal pattern in 18 patients (94.7%) and a demyelinating pattern in one (0.5%). Mononeuropathy multiplex was the most frequent presentation (78.9%), followed by mononeuropathy simplex (10.5%) and polyneuropathy (10.5%). The histopathological study showed the presence of inflammatory infiltrate composed of epithelioid granuloma (42.1%), mononuclear infiltrate (36.8%) or macrophages positive for bacilli (21%). Fibrosis was present in 78.9% of the biopsies. Examination of semithin sections revealed, besides inflammatory infiltrate, myelinated fibre loss (94.7%), remyelination (42%), axonal degeneration (10%) as well as regeneration (31.5%). Based on these results, the pathogenesis of leprosy neuropathy in this group of patients is briefly discussed.
Jardim
Márcia Rodrigues
MR
Laboratory of Leprosy, Department of Tropical Medicine, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
Chimelli
Leila
L
Faria
Suzana Corte-Real
SC
Fernandes
Priscila Valverde
PV
Da Costa Néri
José Augusto
JA
Sales
Ana Maria
AM
Sarno
Euzenir Nunes
EN
Gomes Antunes
Sérgio Luiz
SL
D000328:Adult; D001938:Brazil / Q000453:epidemiology; D004269:DNA, Bacterial / Q000032:analysis; D004576:Electromyography; D005260:Female; D006099:Granuloma / Q000473:pathology; D006801:Humans; D015994:Incidence; D007918:Leprosy / Q000453:epidemiology* / Q000473:pathology*; D008297:Male; D009166:Mycobacterium leprae / Q000235:genetics / Q000302:isolation & purification; D009443:Neuritis / Q000473:pathology; D010525:Peripheral Nerves / Q000473:pathology*; D016133:Polymerase Chain Reaction
D004269:DNA, Bacterial