02371nas a2200265   4500000000100000008004100001653002100042653001200063653001300075100001700088700001200105700001200117700001500129700001500144700001600159700001200175700002200187700002100209245007700230856005100307300001200358490000700370050001800377520171000395       2013                            d10aNeuritic leprosy10aleprosy10aColombia1 aRodríguez G1 aPinto R1 aGomez Y1 aRengifo ML1 aEstrada OL1 aSarmiento M1 aLopez F1 aBeltran-Alzate JC1 aCardona-Castro N00aPure neuritic leprosy in patients from a high endemic region of Colombia  uhttps://leprosyreview.org/article/84/1/04-1050  a41–500 v84  aRODRIGUEZ20133 a<p>Agua de Dios was a leprosariumfor leprosy patients’ obligatory isolation (1872–1961). Its leprosy incidence is the highest in Colombia (1·5–7/10 000). Relapses are common. Government grant of US$ 200 per month subsidy is available to patients with disabilities. Spontaneous consultation with neural symptoms is frequent and simulation to get the subsidy has to be considered. We studied 36 subjects (2007–2009), with ages from 29–78, 19 of them men, with neural symptoms of 6 months to 20 years evolution. All had clinical examination, bacteriological examination, skin and nerve biopsies, electromyography (EMG), PCR for M. leprae, IgM anti-PGL1, and lepromin A. All but two are household contacts of leprosy patients. Symptoms were hypoesthesia of the hands and feet, and difficulty using hands with loss of muscular strength. None had skin lesions. Three had thickening of ulnar nerve. Lepromin was positive in all; bacteriology and biopsies were negative in all. The speed and amplitude of neural conduction were altered in 34 patients; two women had normal EMG and were considered to be feigning the disease; 21 were diagnosed as PNL by clinical, epidemiological and EMG findings; five of them had a positive PCR and one, high titers for IgM anti PGL1. Nine other subjects had diabetes and six carpal tunnel syndrome (CTS). Slow progression of disease, the lack of neural enlargement and the neural biopsies without inflammation suggest that most of these patients could have spontaneously cured PNL, as happens with other cases of paucibacillary leprosy. Diabetes and CTS are important differential diagnoses of PNL. Patients were treated with MDT and received the state subsidy.</p>