title: Clinical, electroneuromyographic and morphological studies of pure neural leprosy in a Brazilian referral centre.
abstract: 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.
authors.affiliation: Laboratory of Leprosy, Department of Tropical Medicine, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil.
authors.forename: Márcia Rodrigues
authors.initials: MR
authors.lastname: Jardim
authors.forename: Leila
authors.initials: L
authors.lastname: Chimelli
authors.forename: Suzana Corte-Real
authors.initials: SC
authors.lastname: Faria
authors.forename: Priscila Valverde
authors.initials: PV
authors.lastname: Fernandes
authors.forename: José Augusto
authors.initials: JA
authors.lastname: Da Costa Néri
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Sales
authors.forename: Euzenir Nunes
authors.initials: EN
authors.lastname: Sarno
authors.forename: Sérgio Luiz
authors.initials: SL
authors.lastname: Gomes Antunes
mesh_terms: 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
chemical_list: D004269:DNA, Bacterial