Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , |
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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/article |
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article |
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publishedVersion |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876 oai:ojs.www.actamedicaportuguesa.com:article/5876 |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876 |
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oai:ojs.www.actamedicaportuguesa.com:article/5876 |
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por eng |
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por eng |
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https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/4361 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/4448 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7390 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7391 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7392 https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/5876/7644 |
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Ordem dos Médicos |
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Ordem dos Médicos |
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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 reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação instacron:RCAAP |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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RCAAP |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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