On the spectrum of leprosy neuropathies: multifocal inflammatory neuropathy heralding leprosy relapse.
We report a 52 year-old woman with a past history of lepromatous leprosy (14 years prior to our first evaluation) who presented with progressive weakness and severe arm/leg pain. CSF analysis revealed elevated protein level with normal cell count. Skin and sural nerve biopsy showed no bacilli. Immunomodulatory treatment led to major improvement on clinical, CSF and electrodiagnostic grounds, but after one year of treatment, skin test revealed leprosy relapse. To our knowledge, this is the first report of a multifocal inflammatory neuropathy heralding leprosy relapse. Extended neurological work-up may be important in unexplained neuropathy progression after leprosy treatment.
Gondim
Francisco de Assis A
Fde A
Departamento de Fisiologia e Farmacologia, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil. gondimfranc@gmail.com,
Thomas
Florian P
FP
de Oliveira
Gisele Ramos
GR
Pimentel
Leonardo Halley C
LH
Bastos
Bruno Pamplona Ranieri
BP
de Castro Costa
Carlos Maurício
CM
D018450:Disease Progression; D005260:Female; D006801:Humans; D007167:Immunotherapy; D015440:Leprosy, Lepromatous / Q000134:cerebrospinal fluid / Q000188:drug therapy / Q000503:physiopathology*; D008875:Middle Aged; D018908:Muscle Weakness / Q000134:cerebrospinal fluid / Q000503:physiopathology* / Q000628:therapy; D010523:Peripheral Nervous System Diseases / Q000134:cerebrospinal fluid / Q000503:physiopathology* / Q000628:therapy; D012008:Recurrence; D012867:Skin / Q000382:microbiology / Q000473:pathology; D013497:Sural Nerve / Q000382:microbiology / Q000473:pathology; D013997:Time Factors; D016896:Treatment Outcome