Ulnar neuropathy as a first sign of HIV infection: a diagnostic challenge for leprosy endemic countries

Jardim, Márcia Rodrigues; Vital, Robson Teixeira; Illarramendi, Ximena; Antunes, Sérgio Luiz Gomes; Nery, José A. C.; Sales, Anna Maria; Moraes, Milton Ozório; Martínez, Alejandra N.; Sampaio, Elizabeth P.; Menezes, Juliana; Gripp, C. B. G.; Morgado, Mariza G.; Sarno, Euzenir Nunes

doi:10.1590/s0004-282x2009000400035

Cited by 1 publication

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“…Take as an example the considerable list of PNL differential diagnoses, which includes vasculitis neuropathy, chronic demyelinating inflammatory polyneuropathy, neural sarcoidosis, and AIDS neuropathy. 9, 18 Stoner 19 considered peripheral nerves as sites in which bacilli are able to evade both the immune response and antibacterial drugs. According to Nilsen and colleagues, 23 AFB are more frequently detected in the nerve than in skin biopsy samples.…”

Section: Discussionmentioning

confidence: 99%

An Attempt to Improve Pure Neural Leprosy Diagnosis Using Immunohistochemistry Tests in Peripheral Nerve Biopsy Specimens

Medeiros

Jardim

Vital

et al. 2014

Applied Immunohistochemistry &Amp; Molecular Morphology

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The diagnosis of pure neural leprosy (PNL) is based on clinical and laboratory data, including the histopathology of nerve biopsy specimens and detection of Mycobacterium leprae DNA by polymerase chain reaction (PCR). Given that histopathologic examination and PCR methods may not be sufficient to confirm the diagnosis, immunolabeling of lipoarabinomanan (LAM) and/or phenolic glycolipid 1 (PGL-1) M. leprae wall components was utilized in the present investigation in an attempt to detect any vestigial presence of M. leprae in acid-fast bacilli (AFB) nerve samples. Twenty-three PNL nerve samples (6 AFB and 17 AFBPCR) were cryosectioned and subjected to LAM and PGL-1 immunohistochemical staining by immunoperoxidase. Five nonleprosy nerve samples were used as controls. The 6 AFB samples showed LAM/PGL-1 immunoreactivity. Among the 17 AFB samples, 8 revealed LAM and/or PGL-1 immunoreactivity. In 17 AFBPCR patients, just 7 yielded LAM and/or PGL-1 nerve results. In the PNL cases, the detection of immunolabeled LAM and PGL-1 in the nerve samples would have contributed to an enhanced diagnostic efficiency in the absence of molecular diagnostic facilities.

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Section: Discussionmentioning

confidence: 99%