@article{3275,
  keywords = {Adolescent, Adult, Aged, Female, Follow-Up Studies, Humans, Leprosy, Tuberculoid, Male, Middle Aged, Mycobacterium leprae, Peripheral nerves},
  author = {Jardim M and Antunes S and Santos AR and Nascimento O and Nery JA and Sales A and Illarramendi X and Duppre NC and Chimelli L and Sampaio E and Sarno E},
  title = {Criteria for diagnosis of pure neural leprosy.},
  abstract = {<p>The clinical diagnosis of pure neural leprosy (PNL) remains a public health care problem mainly because skin lesions-the cardinal features of leprosy-are always absent.Moreover, the identification of the leprosy bacillus is not easily achieved even when a nerve biopsy can be performed. In an attempt to reach a reliable PNL diagnosis in patients referred to our Leprosy Outpatient Clinic, this study employed a variety of criteria. The nerve biopsies performed on the 67 individuals whose clinical, neurological, and electrophysiological examination findings strongly suggested peripheral neuropathy were submitted to M. leprae identification via a polymerase chain reaction (PCR). Mononeuropathy multiplex was the most frequent clinical and electrophysiological pattern of nerve dysfunction, while sensory impairment occurred in 89% of all cases and motor dysfunction in 81%. Axonal neuropathy was the predominant electrophysiological finding, while the histopathological nerve study showed epithelioid granuloma in 14% of the patients, acid fast bacilli in 16%, and nonspecific inflammatory infiltrate and/or fibrosis in 39%. PCR for M. leprae was positive in 47% of the nerve biopsy samples (n=23). PCR, in conjunction with clinical and neurological examination results, can be a powerful tool in attempting to identify and confirm a PNL diagnosis.</p>},
  year = {2003},
  journal = {Journal of neurology},
  volume = {250},
  pages = {806-9},
  month = {2003 Jul},
  issn = {0340-5354},
  doi = {10.1007/s00415-003-1081-5},
  language = {eng},
}