01882nas a2200337   4500000000100000008004100001260001300042653001000055653000900065653002200074653001100096653001100107653001100118653001200129653000900141653001600150653002200166653001300188653002200201653002100223100001700244700001700261700001500278700001500293700001200308245008300320300001000403490000700413520111000420022001401530       2003                            d  c2003 Sep10aAdult10aAged10aAged, 80 and over10aBiopsy10aFemale10aHumans10aleprosy10aMale10aMiddle Aged10aNeural Conduction10aNeuritis10aPeripheral nerves10aPolyneuropathies1 aFreitas MR G1 aNascimento O1 aQuaglino E1 aOliveira A1 aHahn MD00aSmall-fiber polyneuropathy in leprosy without skin changes: study of 17 cases.  a542-60 v613 a<p>Leprosy is one of the most common diseases of the peripheral nerves. In some cases there is only neural involvement without skin changes (neuritic form). The neuropathy has often a distal stocking and glove distribution with thermal and pinprick anesthesia and preservation of proprioception. There is no weakness, the tendon reflexes may be preserved and sometimes the nerves are thickened. We reported 17 patients with a predominantly small-fiber polyneuropathy due to leprosy. All patients had distal temperature and pain anesthesia with different individual variations. The tendon reflexes were normal in seven patients and in eight there was thickening of the nerves. The nerve conduction was normal in three patients. Sural nerve biopsy consisted of: 1) inflammatory infiltrates, 2) vacuolated "foamy" cells, 3) fibrosis of endoneurium, perineurium, and epineurium, 4) partial or total loss of nerve fibers, 5) large number of bacilli. We concluded that in countries where leprosy is frequent, nerve biopsy is an obligatory procedure in patients with predominantly small-fiber polyneuropathy.</p>  a0004-282X