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Clinical, electroneuromyographic and morphological studies of pure neural leprosy in a Brazilian referral centre.

Abstract

Nineteen patients with pure neural leprosy were analysed with clinical examination, electroneuromyography and histopathology of nerve biopsies. Clinical examination showed sensory loss (78.9%), paresis (78.9%), nerve enlargement (68.4%) and nerve pain (42.1%). Electroneuromyographic study revealed an axonal pattern in 18 patients (94.7%) and a demyelinating pattern in one (0.5%). Mononeuropathy multiplex was the most frequent presentation (78.9%), followed by mononeuropathy simplex (10.5%) and polyneuropathy (10.5%). The histopathological study showed the presence of inflammatory infiltrate composed of epithelioid granuloma (42.1%), mononuclear infiltrate (36.8%) or macrophages positive for bacilli (21%). Fibrosis was present in 78.9% of the biopsies. Examination of semithin sections revealed, besides inflammatory infiltrate, myelinated fibre loss (94.7%), remyelination (42%), axonal degeneration (10%) as well as regeneration (31.5%). Based on these results, the pathogenesis of leprosy neuropathy in this group of patients is briefly discussed.

More information

Type
Journal Article
Author
Jardim MR
Chimelli L
Faria SC
Fernandes PV
Da Costa Néri JA
Sales AM
Sarno EN
Gomes Antunes SL
Year of Publication
2004
Journal
Leprosy review
Volume
75
Issue
3
Number of Pages
242-53
Date Published
2004 Sep
Language
eng
ISSN Number
0305-7518
Call Number
Infolep Library - available
Alternate Journal
Lepr Rev
Publication Language
eng