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Publication

The red flags of ulnar neuropathy in leprosy.

Abstract

The diagnosis of pure neural leprosy is more challenging because patients share characteristics with other common pathologies, such as ulnar compression, which should be taken into consideration for differential diagnosis. In this study, we identify ulnar nerve conduction characteristics to aid in the differential diagnosis of ulnar neuropathy (UN) in leprosy and that of non-leprosy etiology. In addition, we include putative markers to better understand the inflammatory process that may occur in the nerve. Data were extracted from a database of people affected by leprosy (leprosy group) diagnosed with UN at leprosy diagnosis. A non-leprosy group of patients diagnosed with mechanical neuropathy (compressive, traumatic) was also included. Both groups were submitted to clinical, neurological, neurophysiological and immunological studies. Nerve enlargement and sensory impairment were significantly higher in leprosy patients than in patients with compressive UN. Bilateral impairment was significantly higher in the leprosy group than in the non-leprosy group. Leprosy reactions were associated to focal demyelinating lesions at the elbow and to temporal dispersion (TD). Clinical signs such as sensory impairment, nerve enlargement and bilateral ulnar nerve injury associated with eletrodiagnostic criteria such as demyelinating finds, specifically temporal dispersion, could be tools to help us decided on the best conduct in patients with elbow ulnar neuropathy and specifically decide if we should perform a nerve biopsy for diagnosis of pure neural leprosy.

More information

Type
Journal Article
Author
Jardim M
Vital R
Illarramendi X
Hacker M
Junqueira B
Pitta I
Pinheiro R
Sarno E
PubMed URL

https://www.ncbi.nlm.nih.gov/pubmed/34797866

Year of Publication
2021
Journal
PloS one
Volume
16
Issue
11
Number of Pages
e0259804
Date Published
01/2021
Language
eng
ISSN Number
1932-6203
DOI
10.1371/journal.pone.0259804
Alternate Journal
PLoS One
PMID
34797866
Publication Language
eng