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, value of other nonspecific histological alterations should be considered along with pertinent clinical, electroneuromyographical and laboratory data (the detection Mycobacterium leprae DNA polymerase chain reaction serum anti-phenolic glycolipid 1 antibodies) to support a possible or probable PNL diagnosis. Three hundred...

Mycobacterium leprae (ML) infection causes nerve damage that often leads to permanent loss of cutaneous sensitivity and limb deformities, but understanding the pathogenesis leprous neuropathy would lead more effective treatments is incomplete. We studied reactional leprosy patients with (n = 9) without 8) acute neuritis. Nerve conduction studies over course episode showed findings demyelination in all Evaluation patient sera revealed no correlation presence antibodies against gangliosides...

Abstract A need still exists to determine the clinical and neurophysiological characteristics of leprosy neuropathy at distinct times disease by different methods that measure various nerve fiber functions. prospective study was performed with 10 paucibacillary (PB) 12 multibacillary (MB) patients evaluated diagnosis one year after cessation multidrug therapy (MDT). Peripheral function assessed clinically means sympathetic skin response, vasomotor reflex, conduction (NCS). At diagnosis, 73%...

Neural pain is a frequent symptom in leprosy disease. There paucity of data regarding neural diagnostics resulting common prescriptive errors when neuritis confused with neuropathic or mixed nociceptive-neuropathic pain. The present study identified important demographic, clinical, and neurophysiological features 42 neuropathy patients presenting (NP). During routine evaluations, were selected asking if they had ever experienced Data analyses their characteristics, clinical examination...

Leprosy reactions are complications that can occur before, during, or after multidrug therapy (MDT) and considered a major cause of nerve damage. Neuritis is an inflammatory process causes function impairment associated with pain tenderness along the nerve. be found in both type 1 2 may also sole manifestation leprosy reaction. The objective this study to describe incidence its association neuropathic pure neural (PNL) patients.We selected 52 patients diagnosed PNL 67 other clinical forms...

Fibrosis is the main cause of irreversible nerve damage in leprosy. Phenotypic changes Mycobacterium leprae (ML)-infected Schwann cells (SCs) have been suggested to mediate this process. We found that SC line cultures stimulated with ML upregulated transforming growth factor-β1 (TGF-β1), and TGF-β1 or induced increased numbers α-smooth muscle actin (α-SMA)-positive characteristic stress fibers. also type I collagen fibronectin mRNA secretion augmented levels SOX9 ZEB1, which are involved...

Pure Neural Leprosy (PNL) is a rare clinical form of leprosy in which patients do not present with the classical skin lesions but have high burden disability associated disease. Clinical characteristics and follow up PNL are still poorly described literature.This paper aims to describe clinical, electrophysiological histopathological patients, as well their evolution after multidrug therapy (MDT).Fifty-two were selected. Clinical, nerve conduction studies (NCS), anti-PGL-1serology evaluated....

Nerve damage in leprosy can be directly induced by Mycobacterium leprae the early stages of infection, however, immunomediated mechanisms add gravity to impairment neural function symptomatic periods disease. This study investigated immunohistochemical expression immunomarkers involved pathogenic nerve damage. These markers selected were CXCL10, CCL2 chemokines and as CD3, CD4, CD8, CD45RA, CD45RO, CD68, HLA-DR, metalloproteinases 2 9 (MMP2 MMP9) occurring biopsy specimens collected from...

The diagnosis of pure neural leprosy (PNL) is based on clinical and laboratory data, including the histopathology nerve biopsy specimens detection Mycobacterium leprae DNA by polymerase chain reaction (PCR). Given that histopathologic examination PCR methods may not be sufficient to confirm diagnosis, immunolabeling lipoarabinomanan (LAM) and/or phenolic glycolipid 1 (PGL-1) M. wall components was utilized in present investigation an attempt detect any vestigial presence acid-fast bacilli...

Fibrosis in the peripheral nerve is end stage of leprous neuropathy and cause resulting permanent neural function impairments. Preventive measures to avoid this irreversible pathological state are a relief strategy for leprosy sufferers.The present study describes frequency fibrosis along with its characterisation pathogenic development.Six-hundred-and-thirteen samples were sorted from 278 (NL) 335 non-leprosy patients (ON). The total number was histologically examined by routine staining...

Focal peripheral neuropathy of the median nerve is mainly caused by a traumatic event or pressure, but it may also be produced systemic illnesses. Among latter, leprosy rare cause.Six cases isolated as first sign were selected from patients with an exclusively neurological complaint initial symptom. The patients, evaluated at National Leprosy Reference Center in Rio de Janeiro, Brazil, followed routine and specialized procedures.Three had pure neural leprosy, 3 skin lesions. Clinical...

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 nerve conduction to aid in the neuropathy (UN) and that non-leprosy etiology. addition, include putative markers better understand inflammatory process may occur nerve. Data were extracted from a database people affected by (leprosy group)...

The lepromatous pole is a stigmatising prototype for patients with leprosy. Generally, these have little or no symptoms of peripheral nerve involvement at the time their diagnosis. However, signs advanced neuropathy would be visible during initial neurological evaluation and could worsen after multidrug therapy (MDT). Disabilities caused by injuries greatly affect patients' lives, pathophysiological mechanisms underlying damage remain unclear.To evaluate outcome in leprosy (LL) persistent...

Abstract Introduction: The use of pedicle screws is the treatment choice in thoracic spinal deformity procedures but insertion and confirmation well-placement challenging due to significant change normal anatomy. Therefore, intraoperative neurophysiological monitoring with triggered-electromyography (t-EMG) highly recommended which if any breach present an ipsilateral response expected. aim expose a cause contralateral t-EMG. Clinical case: Case 14-year-old boy who underwent correction...

Introduction: Herbst’s triad is a rare clinical manifestation of gastroesophageal reflux (GER) associated to hiatal hernia, protein-losing enteropathy, and clubbing. Methods: M.G.S.G., 6 years old, male, white, born in Rio de Janeiro, Brazil, referred the Pediatrics clinic August 2002 for evaluation 6-month history clubbing anemia nonresponsive iron. The patient was pale, with fingers toes bilaterally, without cyanosis. evaluated by several Pediatric subspecialties; Cardiology, Hematology...

Evaluate cytokines as a marker for diferential diagnosis of neuritis and neuropathic pain in leprosy

ABSTRACT Objective To establish the statistical interobserver and intraobserver concordance of thoracic pedicle screw placement in scoliosis surgery, with a 4-week interval between two analyses. Methods Of 55 patients that evaluated intra- concordances positions (according to Abul-Kasim classification) using Kappa coefficient. Results The ranged from coefficient 0.516 0.889 (“moderate” “almost perfect”) analyses performed four weeks apart. Interobserver 0.379 0.633 (“reasonable” “strong”)....

ABSTRACT Objectives Although Watanabe morphological classification is well known, there no consensus of its use among spine surgeons. We propose an analysis the by three observers, one senior and two recently graduated orthopedic surgeons, applicability in pre-operative evaluation. Methods An intraobserver interobserver classifications 937 thoracic pedicles 55 scoliosis patients treated surgically institutions. The average age at time surgery was 16.3 years (10- 50 years). etiologies were:...

Abstract Lepromatous leprosy (LL) patients have evidence of extensive peripheral nerve damage as soon a diagnosis is made, but most them few or no symptoms related to neuropathy. Usually, they do not the cardinal signal neuritis. However, disability caused by injuries has consequences throughout entire life these and pathophysiological mechanisms are still poorly understood. The objective this study was evaluate outcome neuropathy in group LL an attempt understand damage. We evaluated...

OBJECTIVE: To establish an NCS pattern at different stages during the course of leprosy. BACKGROUND: Numerous case reports or series in literature show great variation nerve conduction studies (NCS). The reflection pathological process remains unclear and electrophysiological leprosy neuropathy still needs to be defined. DESIGN/METHODS: Patients from a reference service were evaluated before (n=230), (n=228) after treatment with multidrug therapy (MDT) (n=364). radial, median, ulnar sural...

Mycobacterium leprae and HIV are two infectious agents capable of infecting peripheral nerves and, as a result, inducing neuropathy. In leprosy endemic countries, more refined diagnostic procedures than currently available urgently needed to accurately differential diagnosis between the neuropathies presenting in both since mononeuropathy simplex multiplex well polyneuropathy known occur diseases (Jardim et al., 2003). Pure neural (PNL), for example, presents particularly difficult...