Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy

Detalhes bibliográficos
Autor(a) principal: Veiga, Andreia
Data de Publicação: 2015
Outros Autores: Costa, Alexandre, Taipa, Ricardo, Guimarães, António, Pires, Manuel Melo
Tipo de documento: Artigo
Idioma: por
eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876
Resumo: Introduction: Leprosy is still one of the most frequent causes of peripheral neuropathy. Although regarded as eradicated in Portugal, is still documented in neuropathological study of patients with clinical peripheral neuropathy without proper diagnosis.Material and Methods: Review of the cases of Hansen disease neuropathy diagnosed in Neuropathology Unit of Centro Hospitalar do Porto between 1978 and 2013, atending to gender, age, clinical manifestations and neuropathological findings.Results: Twenty one patients were identified with neuropathological diagnosis of Hansen’s disease neuropathy, predominantly male. The mean age at diagnosis was 52 years, and sensory symptoms predominate as neurological manifestation of disease. Interval between symptoms and diagnosis was 1-38 years. In most nerve samples tuberculoid type of disease was identified. Bacilli were detected in skin and nerve in 44% of cases.Discussion: Mononeuritis is the most common presentation of leprosy but other clinical manifestations are possible, including skin lesions. Infection with M. leprae injures myelinated and unmyelinated fibres, with replacement of nerve tissue by collagen fibrosis. The diagnosis of leprosy is only achieved by neuropathological study of skin lesions and / or peripheral nerve, supported by the identification of the bacillus.Conclusion: Hansen disease remains a public health problem in tropical areas and, although rare, still described in Western countries reason why should still be considered as a diagnostic possibility in the investigation of peripheral neuropathy.
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spelling Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral NeuropathyNeuropatia da Doença de Hansen: Um Diagnóstico a Considerar na Investigação da Neuropatia PeriféricaLeprosyPeripheral Nervous System DiseasesPortugal.Doenças do Sistema Nervoso PeriféricoLepraPortugal.Introduction: Leprosy is still one of the most frequent causes of peripheral neuropathy. Although regarded as eradicated in Portugal, is still documented in neuropathological study of patients with clinical peripheral neuropathy without proper diagnosis.Material and Methods: Review of the cases of Hansen disease neuropathy diagnosed in Neuropathology Unit of Centro Hospitalar do Porto between 1978 and 2013, atending to gender, age, clinical manifestations and neuropathological findings.Results: Twenty one patients were identified with neuropathological diagnosis of Hansen’s disease neuropathy, predominantly male. The mean age at diagnosis was 52 years, and sensory symptoms predominate as neurological manifestation of disease. Interval between symptoms and diagnosis was 1-38 years. In most nerve samples tuberculoid type of disease was identified. Bacilli were detected in skin and nerve in 44% of cases.Discussion: Mononeuritis is the most common presentation of leprosy but other clinical manifestations are possible, including skin lesions. Infection with M. leprae injures myelinated and unmyelinated fibres, with replacement of nerve tissue by collagen fibrosis. The diagnosis of leprosy is only achieved by neuropathological study of skin lesions and / or peripheral nerve, supported by the identification of the bacillus.Conclusion: Hansen disease remains a public health problem in tropical areas and, although rare, still described in Western countries reason why should still be considered as a diagnostic possibility in the investigation of peripheral neuropathy.Introdução: A lepra continua a ser uma das causas mais frequentes de neuropatia periférica. Apesar de tida como erradicada em Portugal, ainda se documenta no estudo neuropatológico de doentes com clínica de neuropatia periférica sem diagnóstico etiológico definido.Material e Métodos: Revisão dos casos neuropatia por doença de Hansen diagnosticados na Unidade de Neuropatologia do Centro Hospitalar do Porto no período de 1978 e 2013 atendendo ao género, idade, manifestações clínicas e achados neuropatológicos.Resultados: Foram identificados 21 doentes com diagnóstico neuropatológico de neuropatia por doença de Hansen, com predomínio do sexo masculino. A idade média ao diagnóstico foi de 52 anos, sendo a sintomatologia sensitiva predominante. O intervalo entre sintomatologia e diagnóstico oscilou entre 1 a 38 anos. Na maioria foi identificada forma tuberculoide em biópsia de nervo e detetados bacilos em pele e nervo em 44% dos casos.Discussão: A mononeurite é a forma mais comum de apresentação de hanseníase, podendo cursar com outras manifestações clínicas incluindo lesões cutâneas. A infeção pelo M. leprae lesiona fibras mielinizadas e não mielinizadas, com substituição do tecido nervoso por colagénio resultando em fibrose. O diagnóstico da lepra é apenas conseguido por estudo neuropatológico das lesões cutâneas e/ou nervo periférico, adjuvado pela identificação do bacilo.Conclusão: A doença de Hansen continua a ser um problema de saúde pública em áreas tropicais e, apesar de rara, ainda descrita em países ocidentais, devendo ser considerada como uma hipótese de diagnóstico na investigação de neuropatia periférica.Ordem dos Médicos2015-06-08info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/pdfapplication/mswordhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876oai:ojs.www.actamedicaportuguesa.com:article/5876Acta Médica Portuguesa; Vol. 28 No. 3 (2015): May-June; 329-332Acta Médica Portuguesa; Vol. 28 N.º 3 (2015): Maio-Junho; 329-3321646-07580870-399Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporenghttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/4361https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/4448https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7390https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7391https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7392https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7644Veiga, AndreiaCosta, AlexandreTaipa, RicardoGuimarães, AntónioPires, Manuel Meloinfo:eu-repo/semantics/openAccess2022-12-20T11:04:36Zoai:ojs.www.actamedicaportuguesa.com:article/5876Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T16:19:12.757803Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
Neuropatia da Doença de Hansen: Um Diagnóstico a Considerar na Investigação da Neuropatia Periférica
title Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
spellingShingle Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
Veiga, Andreia
Leprosy
Peripheral Nervous System Diseases
Portugal.
Doenças do Sistema Nervoso Periférico
Lepra
Portugal.
title_short Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
title_full Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
title_fullStr Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
title_full_unstemmed Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
title_sort Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
author Veiga, Andreia
author_facet Veiga, Andreia
Costa, Alexandre
Taipa, Ricardo
Guimarães, António
Pires, Manuel Melo
author_role author
author2 Costa, Alexandre
Taipa, Ricardo
Guimarães, António
Pires, Manuel Melo
author2_role author
author
author
author
dc.contributor.author.fl_str_mv Veiga, Andreia
Costa, Alexandre
Taipa, Ricardo
Guimarães, António
Pires, Manuel Melo
dc.subject.por.fl_str_mv Leprosy
Peripheral Nervous System Diseases
Portugal.
Doenças do Sistema Nervoso Periférico
Lepra
Portugal.
topic Leprosy
Peripheral Nervous System Diseases
Portugal.
Doenças do Sistema Nervoso Periférico
Lepra
Portugal.
description Introduction: Leprosy is still one of the most frequent causes of peripheral neuropathy. Although regarded as eradicated in Portugal, is still documented in neuropathological study of patients with clinical peripheral neuropathy without proper diagnosis.Material and Methods: Review of the cases of Hansen disease neuropathy diagnosed in Neuropathology Unit of Centro Hospitalar do Porto between 1978 and 2013, atending to gender, age, clinical manifestations and neuropathological findings.Results: Twenty one patients were identified with neuropathological diagnosis of Hansen’s disease neuropathy, predominantly male. The mean age at diagnosis was 52 years, and sensory symptoms predominate as neurological manifestation of disease. Interval between symptoms and diagnosis was 1-38 years. In most nerve samples tuberculoid type of disease was identified. Bacilli were detected in skin and nerve in 44% of cases.Discussion: Mononeuritis is the most common presentation of leprosy but other clinical manifestations are possible, including skin lesions. Infection with M. leprae injures myelinated and unmyelinated fibres, with replacement of nerve tissue by collagen fibrosis. The diagnosis of leprosy is only achieved by neuropathological study of skin lesions and / or peripheral nerve, supported by the identification of the bacillus.Conclusion: Hansen disease remains a public health problem in tropical areas and, although rare, still described in Western countries reason why should still be considered as a diagnostic possibility in the investigation of peripheral neuropathy.
publishDate 2015
dc.date.none.fl_str_mv 2015-06-08
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dc.publisher.none.fl_str_mv Ordem dos Médicos
publisher.none.fl_str_mv Ordem dos Médicos
dc.source.none.fl_str_mv Acta Médica Portuguesa; Vol. 28 No. 3 (2015): May-June; 329-332
Acta Médica Portuguesa; Vol. 28 N.º 3 (2015): Maio-Junho; 329-332
1646-0758
0870-399X
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