The Wide Range of Clinical Manifestations in Leprous Neuropathy: Two Case Reports

Koike, Haruki; Hashimoto, Rina; Tomita, Minoru; Kawagashira, Yuichi; Iijima, Masahiro; Nagamatsu, Masaaki; Sobue, Gen

doi:10.2169/internalmedicine.50.5604

Cited by 5 publications

(4 citation statements)

References 9 publications

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“…In this study, a total of 20 case reports were compiled from nine publications on Japanese patients diagnosed with leprosy between 1990 and 2017 [63][64][65][66][67][68][69][70][71]. The mean age in Japan was high compared to most other countries included in the study (61.4 years).…”

Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Mycobacterium leprae transmission characteristics during the declining stages of leprosy incidence: A systematic review

et al. 2021

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Background Leprosy is an infectious disease caused by Mycobacterium leprae. As incidence begins to decline, the characteristics of new cases shifts away from those observed in highly endemic areas, revealing potentially important insights into possible ongoing sources of transmission. We aimed to investigate whether transmission is driven mainly by undiagnosed and untreated new leprosy cases in the community, or by incompletely treated or relapsing cases. Methodology/Principal findings A literature search of major electronic databases was conducted in January, 2020 with 134 articles retained out of a total 4318 records identified (PROSPERO ID: CRD42020178923). We presented quantitative data from leprosy case records with supporting evidence describing the decline in incidence across several contexts. BCG vaccination, active case finding, adherence to multidrug therapy and continued surveillance following treatment were the main strategies shared by countries who achieved a substantial reduction in incidence. From 3950 leprosy case records collected across 22 low endemic countries, 48.3% were suspected to be imported, originating from transmission outside of the country. Most cases were multibacillary (64.4%) and regularly confirmed through skin biopsy, with 122 cases of suspected relapse from previous leprosy treatment. Family history was reported in 18.7% of cases, while other suspected sources included travel to high endemic areas and direct contact with armadillos. None of the countries included in the analysis reported a distinct increase in leprosy incidence in recent years. Conclusions/Significance Together with socioeconomic improvement over time, several successful leprosy control programmes have been implemented in recent decades that led to a substantial decline in incidence. Most cases described in these contexts were multibacillary and numerous cases of suspected relapse were reported. Despite these observations, there was no indication that these cases led to a rise in new secondary cases, suggesting that they do not represent a large ongoing source of human-to-human transmission.

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Section: Plos Neglected Tropical Diseasesmentioning

confidence: 99%

Mycobacterium leprae transmission characteristics during the declining stages of leprosy incidence: A systematic review

et al. 2021

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“…More than half of the new Japanese cases are reported from Okinawa Prefecture [198], where a few relapsed cases are also found every year [199]. Case reports describe conjugal infection among a couple [200], relapsed leprosy developing drug resistance [201], and leprous neuropathy [202]. Sequelae of leprosy are also documented, such as skin cancers formed at chronic ulcers [203,204], intractable ulcers complicated by diabetes and the sequelae of leprosy [205], visual dysfunction [206,207], and dysmasesis and dysphagia due to facial paralysis [208].…”

Section: Leprosymentioning

confidence: 99%

The current status of neglected tropical diseases in Japan: A scoping review

Harada,

Iwashita,

Moriyasu

et al. 2024

PLoS Negl Trop Dis

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Little attention has been paid to neglected tropical diseases (NTDs) in high-income countries and no literature provides an overview of NTDs in Japan. This scoping review aims to synthesize the latest evidence and information to understand epidemiology of and public health response to NTDs in Japan. Using three academic databases, we retrieved articles that mentioned NTDs in Japan, written in English or Japanese, and published between 2010 and 2020. Websites of key public health institutions and medical societies were also explored. From these sources of information, we extracted data that were relevant to answering our research questions. Our findings revealed the transmission of alveolar echinococcosis, Buruli ulcer, Chagas disease, dengue, foodborne trematodiases, mycetoma, scabies, and soil-transmitted helminthiasis as well as occurrence of snakebites within Japan. Other NTDs, such as chikungunya, cystic echinococcosis, cysticercosis, leishmaniasis, leprosy, lymphatic filariasis, rabies, and schistosomiasis, have been imported into the country. Government agencies tend to organize surveillance and control programs only for the NTDs targeted by the Infectious Disease Control Law, namely, echinococcosis, rabies, dengue, and chikungunya. At least one laboratory offers diagnostic testing for each NTD except for dracunculiasis, human African trypanosomiasis, onchocerciasis, and yaws. No medicine is approved for treatment of Chagas disease and fascioliasis and only off-label use drugs are available for cysticercosis, opisthorchiasis, human African trypanosomiasis, onchocerciasis, schistosomiasis, and yaws. Based on these findings, we developed disease-specific recommendations. In addition, three policy issues are discussed, such as lack of legal frameworks to organize responses to some NTDs, overreliance on researchers to procure some NTD products, and unaffordability of unapproved NTD medicines. Japan should recognize the presence of NTDs within the country and need to address them as a national effort. The implications of our findings extend beyond Japan, emphasizing the need to study, recognize, and address NTDs even in high-income countries.

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“…Although considered exotic and rare, leprous neuropathy occurs in developed countries, due to worldwide travel and immigration [8] and should be considered in the differential diagnosis of neuropathies. Despite widespread implementation of effective multidrug therapy, leprosy has not been eradicated and continues to be a global challenge to health.…”

Section: Epidemiologymentioning

confidence: 99%