Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report

Detalhes bibliográficos
Autor(a) principal: Santos,Lucas Oliveira dos
Data de Publicação: 2021
Outros Autores: Fernandes,Tânia Rita Moreno de Oliveira, Barbosa,Thamyres Rats de Souza, Batista,Jemima Araujo da Silva, Souza,Carlos Dornels Freire de
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Revista da Associação Médica Brasileira (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000100140
Resumo: SUMMARY OBJECTIVE: To review the literature and to report a clinical case with initial suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. METHODS: The study was conducted in two stages. In stage one, a systematic literature review was carried out, with searches performed in the PubMed, Medline, and Lilacs databases, as well as in the leprosy sectoral library of the Virtual Health Library, using the following descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, and amyloid polyneuropathy. The search was carried out on May 28, 2020. Clinical trials, cohort studies, cross-sectional studies, clinical cases, and case studies published in Portuguese, English or Spanish between 2010 and 2020 were included. Stage two reports a case with initial suspicion of pure neural leprosy. Laboratory tests, electroneuromyography, ultrasound, and biopsy of the sural nerve were requested. RESULTS: Twenty-three scientific texts were included. No publications were found that contained both topics together. The challenging diagnosis of pure neural leprosy and the possibility of using auxiliary resources in diagnosis were the most emphasized themes in the studies. In the clinical case, the patient's electroneuromyography showed sensitive and motor polyneuropathy of the lower limbs, which was predominantly sensory and axonal, symmetrical, of moderate intensity, and the mixed type (axonal-demyelinating). Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves; biopsy of the sural nerve showed an accumulation of amorphous eosinophilic material in the nerve path, and Congo red stain showed apple-green birefringence of the deposit under polarized light. The final diagnosis was amyloid neuropathy. CONCLUSIONS: The final clinical diagnosis was amyloid neuropathy. The diagnosis of pure neural leprosy in endemic areas in Brasil is still a challenge for the health system.
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spelling Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case reportLeprosyMycobacterium lepraeAmyloidosisSUMMARY OBJECTIVE: To review the literature and to report a clinical case with initial suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. METHODS: The study was conducted in two stages. In stage one, a systematic literature review was carried out, with searches performed in the PubMed, Medline, and Lilacs databases, as well as in the leprosy sectoral library of the Virtual Health Library, using the following descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, and amyloid polyneuropathy. The search was carried out on May 28, 2020. Clinical trials, cohort studies, cross-sectional studies, clinical cases, and case studies published in Portuguese, English or Spanish between 2010 and 2020 were included. Stage two reports a case with initial suspicion of pure neural leprosy. Laboratory tests, electroneuromyography, ultrasound, and biopsy of the sural nerve were requested. RESULTS: Twenty-three scientific texts were included. No publications were found that contained both topics together. The challenging diagnosis of pure neural leprosy and the possibility of using auxiliary resources in diagnosis were the most emphasized themes in the studies. In the clinical case, the patient's electroneuromyography showed sensitive and motor polyneuropathy of the lower limbs, which was predominantly sensory and axonal, symmetrical, of moderate intensity, and the mixed type (axonal-demyelinating). Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves; biopsy of the sural nerve showed an accumulation of amorphous eosinophilic material in the nerve path, and Congo red stain showed apple-green birefringence of the deposit under polarized light. The final diagnosis was amyloid neuropathy. CONCLUSIONS: The final clinical diagnosis was amyloid neuropathy. The diagnosis of pure neural leprosy in endemic areas in Brasil is still a challenge for the health system.Associação Médica Brasileira2021-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302021000100140Revista da Associação Médica Brasileira v.67 n.1 2021reponame:Revista da Associação Médica Brasileira (Online)instname:Associação Médica Brasileira (AMB)instacron:AMB10.1590/1806-9282.67.01.20200422info:eu-repo/semantics/openAccessSantos,Lucas Oliveira dosFernandes,Tânia Rita Moreno de OliveiraBarbosa,Thamyres Rats de SouzaBatista,Jemima Araujo da SilvaSouza,Carlos Dornels Freire deeng2021-06-16T00:00:00Zoai:scielo:S0104-42302021000100140Revistahttps://ramb.amb.org.br/ultimas-edicoes/#https://old.scielo.br/oai/scielo-oai.php||ramb@amb.org.br1806-92820104-4230opendoar:2021-06-16T00:00Revista da Associação Médica Brasileira (Online) - Associação Médica Brasileira (AMB)false
dc.title.none.fl_str_mv Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
title Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
spellingShingle Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
Santos,Lucas Oliveira dos
Leprosy
Mycobacterium leprae
Amyloidosis
title_short Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
title_full Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
title_fullStr Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
title_full_unstemmed Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
title_sort Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report
author Santos,Lucas Oliveira dos
author_facet Santos,Lucas Oliveira dos
Fernandes,Tânia Rita Moreno de Oliveira
Barbosa,Thamyres Rats de Souza
Batista,Jemima Araujo da Silva
Souza,Carlos Dornels Freire de
author_role author
author2 Fernandes,Tânia Rita Moreno de Oliveira
Barbosa,Thamyres Rats de Souza
Batista,Jemima Araujo da Silva
Souza,Carlos Dornels Freire de
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Santos,Lucas Oliveira dos
Fernandes,Tânia Rita Moreno de Oliveira
Barbosa,Thamyres Rats de Souza
Batista,Jemima Araujo da Silva
Souza,Carlos Dornels Freire de
dc.subject.por.fl_str_mv Leprosy
Mycobacterium leprae
Amyloidosis
topic Leprosy
Mycobacterium leprae
Amyloidosis
description SUMMARY OBJECTIVE: To review the literature and to report a clinical case with initial suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. METHODS: The study was conducted in two stages. In stage one, a systematic literature review was carried out, with searches performed in the PubMed, Medline, and Lilacs databases, as well as in the leprosy sectoral library of the Virtual Health Library, using the following descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, and amyloid polyneuropathy. The search was carried out on May 28, 2020. Clinical trials, cohort studies, cross-sectional studies, clinical cases, and case studies published in Portuguese, English or Spanish between 2010 and 2020 were included. Stage two reports a case with initial suspicion of pure neural leprosy. Laboratory tests, electroneuromyography, ultrasound, and biopsy of the sural nerve were requested. RESULTS: Twenty-three scientific texts were included. No publications were found that contained both topics together. The challenging diagnosis of pure neural leprosy and the possibility of using auxiliary resources in diagnosis were the most emphasized themes in the studies. In the clinical case, the patient's electroneuromyography showed sensitive and motor polyneuropathy of the lower limbs, which was predominantly sensory and axonal, symmetrical, of moderate intensity, and the mixed type (axonal-demyelinating). Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves; biopsy of the sural nerve showed an accumulation of amorphous eosinophilic material in the nerve path, and Congo red stain showed apple-green birefringence of the deposit under polarized light. The final diagnosis was amyloid neuropathy. CONCLUSIONS: The final clinical diagnosis was amyloid neuropathy. The diagnosis of pure neural leprosy in endemic areas in Brasil is still a challenge for the health system.
publishDate 2021
dc.date.none.fl_str_mv 2021-01-01
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