Clinical and diagnostic aspects of the primarily neural leprosy

• Autor(a) principal: Garbino, José Antonio
• Data de Publicação: 2004
• Outros Autores: Ura, Somei, Belone, Andréa de Faria Fernandes, Marciano, Lúcia Helena Soares Camargo, Fleury, Raul Negrão
• Tipo de documento: Artigo
• Idioma: por; eng
• Título da fonte: Hansenologia Internationalis (Online)
• Texto Completo: https://periodicos.saude.sp.gov.br/hansenologia/article/view/36384
• topic: hanseníase; neuropatia; biópsia de nervo; leprosy; neuropathy; nerve biopsy

A total of 33 patients, 28 males and five females, from nine to 87 years of age, wi th suspec ted leprosy associated peripheral neuropathy, without detectable skin lesion or positive skin bacilloscopy, were studied during the period of 1994 to 2004. Patients were s u bmi t t e d t o d e rma t o l o g i c a l a n d n e u r o l o g i c a l examination, electrophysiologic tests, Mitsuda reaction and nerve biopsy. Samples for histopathological examswere stained with hematoxillin-eosin, Faraco-Fite and immunohistochemistry with anti -BCG antibodies. Among patients with suspected leprosy, the clinical presentation of polyneuropathy occurred in 17 (51.51%) patients while 13 (39.39%) presented mononeuropathy mu l t ip l ex an d 3 ( 9 .1%) mo n o n e ur op a t hy . T h e hematoxillin-eosin and Faraco-Fite stainings confirmed the leprosy diagnosis in 10 (30.30%) patients. Three patients presented a borderline pattern, two tuberculoidpattern and no characteristic histological pattern was observed in the remaining five patients. The final classification depended on the clinical-histological correlation. Immunohistochemistry increased the diagnosis to 11 (33.33%) cases. Among the remaining 22 patients, three patients had leprosy confirmed increasing the diagnosis to 14 (42.43%) cases. One was clinicallyunderstood as a primarily neural leprosy, probably tuberculoid form of the childhood. From the remaining patients, 19 (57.57%) were excluded during the follow-up. The primarily neural leprosy (PNL) is an unusual leprosy presentation and a complex form to diagnose. The clinical follow-up accompanied by the improvement of histopathological examination of the nerve may add more accuracy to the investigation of the suspected leprosy neuropathies.