01950nas a2200361   4500000000100000008004100001260001300042653001500055653001000070653001000080653001100090653001400101653001100115653003000126653001200156653000900168653001600177653002500193653001300218653001300231653002200244653001600266100001500282700001500297700001700312700001200329245006100341856004100402300000900443490000700452520111500459022001401574       1980                            d  c1980 Mar10aAdolescent10aAdult10aChild10aFemale10aGranuloma10aHumans10aHypersensitivity, Delayed10aleprosy10aMale10aMiddle Aged10aMycobacterium leprae10aNecrosis10aNeuritis10aPeripheral nerves10aUlnar nerve1 aChandi S M1 aChacko C J1 aFritschi E P1 aJob C K00aSegmental necrotizing granulomatous neuritis of leprosy.  uhttp://ila.ilsl.br/pdfs/v48n1a06.pdf  a41-70 v483 a<p>In leprosy, the occurrence of necrotizing nodular lesions in peripheral nerves is a relatively uncommon complication. Despite clinical and gross similarities, there are microscopical differences among groups of such cases, indicating that in all probability different pathogenetic mechanisms are operative. Furthermore, the vast majority of such cases are not true abscesses but are characterized by caseous necrosis and granulomatous inflammation. The traditional collective name "nerve abscess" is therefore inappropriate. Presented herein is an analytic study of 30 cases of the commonest variant, which we suggest should be called segmental necrotizing granulomatous neuritis of leprosy (SNGN). This lesion commonly affects the right ulnar nerve just above the elbow and occurs most often in those with the borderline tuberculoid form of leprosy. It appears to represent the result of a hypersensitivity phenomenon marked by a preponderance of epithelioid cells rather than a reaction of immunity in which lymphocytes predominate. Acid fast bacilli were demonstrable in the lesion in 77% of cases.</p>
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