Magnetic resonance imaging in pure neural leprosy

Beltrame, Anna; Barabino, Gianfranco; Cicciò, Carmelo; Monteiro, Geraldo Badona; Cavalchini, Alberto; Carbognin, Giovanni; Bisoffi, Zeno

doi:10.1016/j.ijid.2017.04.022

Cited by 5 publications

(4 citation statements)

References 4 publications

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“…In these cases, when the observed pattern is only of neural impairment, the physician must use other auxiliary resources that help to exclude other diseases that manifest with neuropathy and allow for confirmation of the diagnosis of neural leprosy 1,11,18,19 . Among the resources, electroneuromyography, ultrasonography 22,29,34 , biopsies of peripheral nerves 21,24 , and even magnetic resonance imaging of nerve trunks 27 stand out. Anti-PGL-1 (phenolic glycolipid antigen 1) serology and quantitative polymerase chain reaction can also be useful 1,10,19 .…”

Section: Discussionmentioning

confidence: 99%

“…It should be noted that no text addressed both themes together. Case reports, with the largest number of publications (14 investigations), stood out 11,18,20,21,[25][26][27][29][30][31]33,34,36,37 . Full-text reading (n=111)…”

Section: Systematic Reviewmentioning

confidence: 99%

“…The studies emphasized the challenging diagnosis of pure neural leprosy 16,17,25,27,30 and the need for advances in the development of diagnostic methods 18,32 , such as imaging tests (magnetic resonance imaging 27 and ultrasound 22,29,34 ), cytology and histopathology 21,23,24,28,38 , and serological and genomic tests 19,35 .…”

Section: Eligibilitty Inclusionmentioning

confidence: 99%

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Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report

Santos

Fernandes

Barbosa

et al. 2021

Rev. Assoc. Med. Bras.

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OBJECTIVE:To review the literature and to report a clinical case with initial suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. METHODS:The study was conducted in two stages. In stage one, a systematic literature review was carried out, with searches performed in the PubMed, Medline, and Lilacs databases, as well as in the leprosy sectoral library of the Virtual Health Library, using the following descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, and amyloid polyneuropathy. The search was carried out on May 28, 2020. Clinical trials, cohort studies, crosssectional studies, clinical cases, and case studies published in Portuguese, English or Spanish between 2010 and 2020 were included.Stage two reports a case with initial suspicion of pure neural leprosy. Laboratory tests, electroneuromyography, ultrasound, and biopsy of the sural nerve were requested.RESULTS: Twenty-three scientific texts were included. No publications were found that contained both topics together. The challenging diagnosis of pure neural leprosy and the possibility of using auxiliary resources in diagnosis were the most emphasized themes in the studies. In the clinical case, the patient's electroneuromyography showed sensitive and motor polyneuropathy of the lower limbs, which was predominantly sensory and axonal, symmetrical, of moderate intensity, and the mixed type (axonal-demyelinating). Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves; biopsy of the sural nerve showed an accumulation of amorphous eosinophilic material in the nerve path, and Congo red stain showed apple-green birefringence of the deposit under polarized light. The final diagnosis was amyloid neuropathy. CONCLUSIONS:The final clinical diagnosis was amyloid neuropathy. The diagnosis of pure neural leprosy in endemic areas in Brasil is still a challenge for the health system.

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Section: Discussionmentioning

confidence: 99%

Section: Systematic Reviewmentioning

confidence: 99%

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Pure neural leprosy or amyloid neuropathy? Systematic review and clinical case report

Santos

Fernandes

Barbosa

et al. 2021

Rev. Assoc. Med. Bras.

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“…Several electrophysiological, ultrasonographic, Electroneuromyography (ENMG) and histological techniques are also developed and adapted to diagnose PNL (80,81). Subsequently, many other sensitive techniques have been used previously or in development that can be updated and further used as a point of care tools in the laboratory as well as field settings as diagnostic tools such as variants of PCR (8,24,71,72,82), colorimetric assays (83), Biomarkers (66), Filter paper (84), peptide-nucleic-acid-ELISA (85,86), reverse line probe (87), synthetic peptide reagents (88)(89)(90), Ultrasonography (50)(51)(52), Fingerstick test (91), Electrochemical biosensors (53), LAMP (61)(62)(63), MRI (54)(55)(56), LF Assays (92,93), Fluorescent staining (47)(48)(49) and Artificial Intelligence to combat leprosy (44,45). Here we will be discussing budding techniques that have the potential to be used in the field settings easily.…”

Section: Different Diagnostics Approaches For the Detection Of M Lepraementioning

confidence: 99%

Advances in the Diagnosis of Leprosy

Sharma¹,

Singh²

2022

Front. Trop. Dis

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Leprosy is a public health issue, and early detection is critical to avert disability. Despite the global attempt to eradicate this disease as a public health problem, it remains an important cause of global neurological disability. India, Brazil and Indonesia share more than 70% of the cases. The reduction of new cases is a priority in the WHO global strategy 2021-2030 which aims to reduce disease transmission in the community by diagnosing cases and identifying subclinical infection. The clinical manifestations of leprosy range from a few to several lesions. The identification remains difficult due to the limited sensitivity of traditional approaches based on bacillary counts of skin smears and histology. To aid in the diagnosis of this disease, molecular biology, and biotechnological technologies have been applied, each with its own set of benefits and downsides despite providing an essential tool to validate the clinical diagnosis of leprosy. Because of this, it is strongly recognized that specific, inexpensive point of care technologies should be developed, particularly to identify asymptomatic M. leprae infections or leprosy nearer to the suspected cases seeking medical attention. Thus, this review will provide an overview of the advancements in leprosy diagnosis over the world. The purpose of this review is to improve our understanding of the outcomes of current tests and technologies used in leprosy diagnosis and to emphasize critical aspects concerning the detection of leprosy bacilli.

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