Criteria for diagnosis of pure neural leprosy

@article{Jardim2003CriteriaFD,
  title={Criteria for diagnosis of pure
neural leprosy},
  author={M�rcia R. Jardim and S�rgio L. G. Antunes and Adalberto Rezende Santos and Osvaldo Jos{\'e} Moreira Nascimento and Jos{\'e} Augusto C. Nery and Anna Maria Sales and Ximena Illarramendi and N�dia Duppre and Leila Chimelli and Elizabeth Pereira Sampaio and Euzenir Nunes Sarno},
  journal={Journal of Neurology},
  year={2003},
  volume={250},
  pages={806-809}
}
Abstract.The clinical diagnosis of pure neural leprosy (PNL) remains a public health care problem mainly because skin lesions—the cardinal features of leprosy—are always absent.Moreover, the identification of the leprosy bacillus is not easily achieved even when a nerve biopsy can be performed. In an attempt to reach a reliable PNL diagnosis in patients referred to our Leprosy Outpatient Clinic, this study employed a variety of criteria. The nerve biopsies performed on the 67 individuals whose… 
Revisiting primary neural leprosy: Clinical, serological, molecular, and neurophysiological aspects
TLDR
PNL is not a synonym of pure neural leprosy, as this condition may include a generalized immune response and also a skin involvement, documented by molecular findings.
Pure Neural Leprosy
TLDR
The clinical and epidemiological findings plus with the electroneuromyography alteration were finally accepted as sufficient criteria to diagnose PNL.
Pathological, ultrasonographic, and electrophysiological characterization of clinically diagnosed cases of pure neuritic leprosy
TLDR
A comprehensive electrophysiologic, ultrasonographic, and histological evaluation may be helpful in establishing a diagnosis of PNL with greater confidence, while ruling out other non‐leprosy diagnoses.
Leprosy and the peripheral nervous system: Basic and clinical aspects
TLDR
Electrodiagnostic findings early in the disease reveal demyelinating features, such as slowing of conduction velocity and prolongation of latencies, but as the disease progresses secondary axonal damage commonly ensues, and electrodes are used to monitor for toxicity secondary to therapy, particularly thalidomide‐associated neuropathy.
Neural Leprosy: A case report
TLDR
Serological test of anti PGL-1 can be a marker and a useful tool as an additional test to confirm the diagnosis, especially for patients with nerve impairments, and both diagnosis and treatment require multidisciplinary approach.
Microscopic leprosy skin lesions in primary neuritic leprosy.
Pure Neuritic Leprosy in India : an Appraisal 1
TLDR
PNL is a distinct subset of disease frequently seen in India and there is need to pay more attention to this form of leprosy and diagnose and treat patients earlier to prevent deformities and sequelae of nerve damage.
[Diagnosis and treatment of leprous neuropathy in practice].
Role of PGL-I antibody detection in the diagnosis of pure neural leprosy.
Pure neural leprosy (PNL) is difficult to diagnose because skin lesions and acid-fast bacilli (AFB) in slit smears are absent. At present, the gold standard for PNL diagnosis is the histopathological
Follow-up assessment of patients with Pure Neural Leprosy in a reference center in Rio de Janeiro—Brazil
TLDR
unique characteristics of PNL in the spectrum of leprosy are highlighted in an attempt to facilitate the diagnosis and management of these patients.
...
...

References

SHOWING 1-10 OF 22 REFERENCES
A clinical, immunological, and histological study of neuritic leprosy patients.
  • G. Kaur, B. K. Girdhar, K. Desikan
  • Medicine, Biology
    International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association
  • 1991
TLDR
The results show that neuritic leprosy patients also have a spectrum and none of the clinical parameters, including the number and distribution of affected nerves, the immune response and the nerve histology, were found to be inter-related.
Clinical and histopathological observations on pure neuritic leprosy.
TLDR
Clinical and histopathological observations on twelve patients of pure neuritic leprosy are presented, the interesting observations being that all the patients showed lepromin positivity and a narrower histological spectrum, ranging from TT to BB only.
Leprotic involvement of peripheral nerves in the absence of skin lesions. Case report and literature review.
Clinical and histopathological observations on pure neuritic leprosy.
TLDR
Clinical and histopathological observations on twelve patients of pure neuritic leprosy are presented, the interesting observations being that all the patients showed lepromin positivity and a narrower histological spectrum, ranging from TT to BB only.
Asymptomatic nerve hypertrophy in lepromatous leprosy: a clinical, electrophysiological and morphological study
TLDR
Both infection of Schwann cells and secretory products released by mononuclear cells involved in the inflammatory process are likely to play a role in the lesions of nerve fibres observed in early stages of lepromatous leprosy.
A study of pure neuritic leprosy: clinical experience.
TLDR
Involvement of upper extremity and right ulnar nerve in particular was the most common clinical feature and none of the patients developed skin lesions while on anti-leprosy treatment.
Neuritic leprosy: epidemiology and therapeutic responsiveness.
TLDR
Mononeuritis involving the ulnar nerve, followed by the common peroneal nerve was the commonest presentation, and the subsequent diagnosis in cases developing skin lesions was borderline--lepromatous in one case, borderline-tuberculoid in 4 cases, tuberculoids in 2 cases and indeterminate in 1 case.
Role of polymerase chain reaction in the diagnosis of early leprosy.
For 39 patients suspected of early leprosy, skin biopsies of the lesions were done and bisected. One piece was used for histopathologic examination and the other for polymerase chain reaction (PCR)
Polymerase chain reaction assay for the detection and identification of Mycobacterium leprae in patients in the United States.
TLDR
Experience with formalin-fixed, paraffin-embedded tissues, frozen tissues, and tissue lysates referred for detection of M. leprae DNA by a polymerase chain reaction (PCR) assay during the past 4 years was reviewed.
Detection of Mycobacterium leprae in nerve lesions by the polymerase chain reaction.
  • P. Chemouilli, S. Woods, G. Said, S. Cole
  • Biology, Medicine
    International journal of leprosy and other mycobacterial diseases : official organ of the International Leprosy Association
  • 1996
TLDR
A simple procedure is described for the detection of Mycobacterium leprae by the polymerase chain reaction in nerve biopsies sectioned with a cryostat and then treated with proteinase K, which yielded positive results.
...
...