01888nas a2200277   4500000000100000008004100001260001600042653003000058653001200088653001400100100002400114700001400138700001300152700001800165700001200183700001300195700001600208700001600224700001500240700001200255700001400267245012700281050001900408520116900427022001401596       2013                            d  c2013 May 2210aPure neural leprosy (PNL)10aleprosy10adiagnosis1 aFerreira Medeiros M1 aJardim MR1 aVital RT1 aCosta Nery JA1 aSales A1 aMoraes M1 aChimelli LM1 aPessolani M1 aFerreira H1 aSarno E1 aAntunes S00aAn attempt to improve pure neural leprosy diagnosis using immunohistochemistry tests in peripheral nerve biopsy specimens.  aMEIDEIROS 20133 aThe diagnosis of pure neural leprosy (PNL) is based on clinical and laboratory data, including the histopathology of nerve biopsy specimens and detection of Mycobacterium leprae DNA by polymerase chain reaction (PCR). Given that histopathologic examination and PCR methods may not be sufficient to confirm the diagnosis, immunolabeling of lipoarabinomanan (LAM) and/or phenolic glycolipid 1 (PGL-1) M. leprae wall components was utilized in the present investigation in an attempt to detect any vestigial presence of M. leprae in acid-fast bacilli (AFB) nerve samples. Twenty-three PNL nerve samples (6 AFB and 17 AFBPCR) were cryosectioned and subjected to LAM and PGL-1 immunohistochemical staining by immunoperoxidase. Five nonleprosy nerve samples were used as controls. The 6 AFB samples showed LAM/PGL-1 immunoreactivity. Among the 17 AFB samples, 8 revealed LAM and/or PGL-1 immunoreactivity. In 17 AFBPCR patients, just 7 yielded LAM and/or PGL-1 nerve results. In the PNL cases, the detection of immunolabeled LAM and PGL-1 in the nerve samples would have contributed to an enhanced diagnostic efficiency in the absence of molecular diagnostic facilities.  a1533-4058