Histopathological examination of nerve samples from pure neural leprosy patients: obtaining maximum information to improve diagnostic efficiency

Abstract

Nerve biopsy examination is an important auxiliary procedure for diagnosing pure neural leprosy (PNL).

Lepromatous leprosy patients produce antibodies that recognise non-bilayer lipid arrangements containing mycolic acids

“…The use of anti-PGL-1 antibodies has been proposed as an adjunct early leprosy diagnostic marker for household contacts of patients with leprosy (Bazan-Furine et al 2011). The histopathological examination of nerve samples, in conjunction with clinical, epidemiological and laboratory data, has also been investigated for use in the diagnosis of pure neural leprosy (Antunes et al 2012). Because antibodies that bind nonbilayer lipid arrangements may have pathogenic activity in the development of skin and renal lesions, they may be a useful tool for the early diagnosis of LL.…”

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

“…Frozen nerve biopsy samples collected from 28 patients in treatment at the Souza Arau´jo Outpatient Service of the Oswaldo Cruz Foundation in Rio de Janeiro, RJ, Brazil, were sorted into 2 groups: (1) PNL group (n = 23) and (2) other neuropathies (ON group, n = 5). The patients had been previously diagnosed as PNL, as can be seen in 3 previous publications by our group, 3,4,9 in which neuroelectrophysiological, histopathologic, and other laboratory parameters were applied.…”

“…In fact, a probable diagnosis is ascertained by the presence of nonspecific mononuclear infiltrate in the nerve. 9 However, if AFB cannot be detected, other laboratory procedures such as detection of M. leprae DNA [10][11][12] and antiphenolic glycolipid 1 (PGL-1) antibodies must be performed to confirm a leprosy diagnosis. 4 Detection of M. leprae DNA was used by Jardim et al 3 and Bezerra et al 10 as an additional parameter to define a PNL diagnosis.…”

Infectious and tropical neuropathies

“…Additionally, PCR on nerve biopsy tissue and enzyme-linked immunosorbent assay (ELISA) to detect anti-phenolic glycolipid 1 IgM antibodies may be helpful [13]. Biopsy is also useful to assess the efficacy of treatment, since cutaneous lesions regress but neurological manifestations persist in some cases and viable bacilli may be present in the nerve.…”