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Pure neural leprosy—mind the diagnosis
Abstract
Introduction:
Pure Neural Leprosy (PNL) is a known clinical diagnosis of leprosy. There is great epidemiological variability in the diagnosis and there appears to be no consensus about its definition and classification. Given the reported prevalence it is for operational reasons important that there is consensus about its definition, classification and treatment.
Method:
The TENLEP (Treatment of early Neuropathy in LEProsy) database was used to analyze patients that were enrolled with a diagnosis of PNL to determine proportions of patients with PNL enrolled in six research sites in four geographically different leprosy endemic countries. Demographics were looked at and frequency of nerves involved in PNL.
The database consists of data of 1240 patients that were enrolled to determine efficacy of prednisolone in the prevention of clinical neuropathy (N = 372) or the treatment of clinical neuropathy (N = 868).
Results:
In the clinical trial 76 (8.8%), and in the subclinical trial 28 (7.5%) patients were enrolled with the diagnosis of PNL. There was great variability in diagnosis and enrollment of PNL patients in the two cohorts. The ulnar nerve is the most affected (enlargement and/or function loss) of all nerves.
Conclusion:
Our findings corroborate with the findings of other studies regarding the occurrence of PNL. The diagnosis needs to be carefully made and additional tests or assessments may be needed before a definitive diagnosis of Pure Neural Leprosy can be made.
Pure Neural Leprosy (PNL) is a known clinical diagnosis of leprosy. There is great epidemiological variability in the diagnosis and there appears to be no consensus about its definition and classification. Given the reported prevalence it is for operational reasons important that there is consensus about its definition, classification and treatment.
Method:
The TENLEP (Treatment of early Neuropathy in LEProsy) database was used to analyze patients that were enrolled with a diagnosis of PNL to determine proportions of patients with PNL enrolled in six research sites in four geographically different leprosy endemic countries. Demographics were looked at and frequency of nerves involved in PNL.
The database consists of data of 1240 patients that were enrolled to determine efficacy of prednisolone in the prevention of clinical neuropathy (N = 372) or the treatment of clinical neuropathy (N = 868).
Results:
In the clinical trial 76 (8.8%), and in the subclinical trial 28 (7.5%) patients were enrolled with the diagnosis of PNL. There was great variability in diagnosis and enrollment of PNL patients in the two cohorts. The ulnar nerve is the most affected (enlargement and/or function loss) of all nerves.
Conclusion:
Our findings corroborate with the findings of other studies regarding the occurrence of PNL. The diagnosis needs to be carefully made and additional tests or assessments may be needed before a definitive diagnosis of Pure Neural Leprosy can be made.
More information
Type
Journal Article