02148nas a2200289   4500000000100000008004100001260003700042653001100079653002500090653001100115653002500126653002200151100001400173700001500187700001400202700001300216700001800229700001800247700001600265700001200281245015000293856004800443300001100491490000800502520133400510022001401844       2012                            d  c2012 MarbScieloaRio de Janeiro10aBiopsy10aCase-Control Studies10aHumans10aLeprosy, Tuberculoid10aPeripheral nerves1 aAntunes S1 aChimelli L1 aJardim MR1 aVital RT1 aCosta Nery JA1 aCôrte-Real S1 aHacker MAVB1 aSarno E00aHistopathological examination of nerve samples from pure neural leprosy patients: obtaining maximum information to improve diagnostic efficiency.  uhttp://www.scielo.br/pdf/mioc/v107n2/15.pdf  a246-530 v1073 a<p>Nerve biopsy examination is an important auxiliary procedure for diagnosing pure neural leprosy (PNL). When acid-fast bacilli (AFB) are not detected in the nerve sample, the value of other nonspecific histological alterations should be considered along with pertinent clinical, electroneuromyographical and laboratory data (the detection of Mycobacterium leprae DNA with polymerase chain reaction and the detection of serum anti-phenolic glycolipid 1 antibodies) to support a possible or probable PNL diagnosis. Three hundred forty nerve samples [144 from PNL patients and 196 from patients with non-leprosy peripheral neuropathies (NLN)] were examined. Both AFB-negative and AFB-positive PNL samples had more frequent histopathological alterations (epithelioid granulomas, mononuclear infiltrates, fibrosis, perineurial and subperineurial oedema and decreased numbers of myelinated fibres) than the NLN group. Multivariate analysis revealed that independently, mononuclear infiltrate and perineurial fibrosis were more common in the PNL group and were able to correctly classify AFB-negative PNL samples. These results indicate that even in the absence of AFB, these histopathological nerve alterations may justify a PNL diagnosis when observed in conjunction with pertinent clinical, epidemiological and laboratory data.</p>  a1678-8060