Regenerating hope: platelet-rich plasma as adjunct therapy for acute neuritis, recurrent nerve damage, and progressive disabilities in leprosy

Leprosy is a major cause of peripheral neuropathy, with patients experiencing acute or recurrent neuritis, progressive motor deficits, and pain, despite multidrug therapy and prolonged corticosteroid or NSAID use. Platelet-rich plasma (PRP), an autologous growth factor-rich concentrate, was assessed as an adjunctive regenerative treatment for leprosy-induced neuritis and disability, assessing changes in pain, neuritis grade, and motor function before and after therapy. Five patients with leprosy-related neuritis or neuropathy unresponsive to multidrug therapy, systemic steroids, and NSAIDs received perineural PRP prepared by the double-spin method. Ultrasound-guided PRP was injected around the affected ulnar, common peroneal, and posterior tibial nerves. Outcomes were evaluated using the Visual Analogue Scale (VAS) for pain and motor impairment, neuritis grade on palpation, and voluntary muscle testing (VMT) at baseline and day 5, with a 4-week follow-up. All treated nerves showed marked pain reduction, with very high baseline VAS scores decreasing to minimal or no pain by day 5 (about 80–60 to 0). Neuritis improved from Grade 2/3 to Grade 0 in most nerves within 5 days. VMT remained stable or showed early functional gains, with VAS-graded motor impairment improving from 70–50 to 40–20. No local or systemic complications occurred; recurrent ned nerves, and analgesic and steroid requirements decreased. Ultrasound-guided perineural PRP appears safe and promising for leprosy-associated neuritis and neuropathy, enabling rapid pain relief, neuritis downgrading, early functional improvement, and reduced steroid exposure and warrants larger controlled trials to standardise protocols and confirm long-term efficacy.