Polyneuritic variant of pure neuritic leprosy with extensive involvement of peripheral nerves and sparing of the polioߚaffected limb: a rare case report

Pradhan, Swetalina; Padhi, Tanmay; Panda, Braja Behari; Nayak, Bibhu Prasad

doi:10.1111/ddg.12697

Cited by 4 publications

(4 citation statements)

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“…It has a predilection for Schwann cells of the peripheral nervous system. Invasion of Schwann cells leads to neurological damage, which causes sensory and/or motor neurological defects and subsequent deformity and disability associated with the disease [2].…”

Section: Discussionmentioning

confidence: 99%

Uncharacteristic erythematous plaques

Gamage

Schumny

Darr-Foit

et al. 2020

J Deutsche Derma Gesell

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Section: Discussionmentioning

confidence: 99%

Uncharacteristic erythematous plaques

Gamage

Schumny

Darr-Foit

et al. 2020

J Deutsche Derma Gesell

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“…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%

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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“…Die Lepra wird durch das Bakterium Mycobacterium leprae verursacht und ist eine vielgestaltige chronische Infektionskrankheit, die sich in einem breiten Spektrum pauci-bis multibazillärer Verläufe manifestiert [ 1 ] . Viele Autoren haben über sehr ungewöhnliche klinische Manifestationsformen der Lepra berichtet, darunter Fälle mit Photosensibilität und generalisierten erworbenen Cutis-laxa-ähnlichen Symptomen [ 2 ] , mit persistierenden Angioödemen und Sinusitis-artigem Verlauf bei multibazillärer Erkrankung [ 3 ] oder mit polyneuritischer, rein neuraler Lepra mit ausgedehnter Beteiligung der peripheren Nerven unter Aussparung einer von Poliomyelitis betroffenen Extremität [ 4 ] . Der Bezeichnung "großer Imitator" für die Krankheit scheint gerechtfertigt [ 5 ] .…”

Section: Clinical Letterunclassified