• DOI:10.1007/s00415-003-1081-5
• Corpus ID: 20070335

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}
}

• M�rcia R. Jardim, S. Antunes, +8 authors E. Sarno
• Published 1 July 2003
• Medicine, Biology
• Journal of Neurology

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 clinical, neurological, and
electrophysiological examination findings strongly suggested
peripheral neuropathy were submitted to M. leprae identification via a
polymerase chain reaction (PCR). Mononeuropathy multiplex was
the most frequent clinical and electrophysiological pattern of
nerve dysfunction, while sensory impairment occurred in 89% of
all cases and motor dysfunction in 81%. Axonal neuropathy was
the predominant electrophysiological finding, while the
histopathological nerve study showed epithelioid granuloma in
14% of the patients, acid fast bacilli in 16%, and nonspecific
inflammatory infiltrate and/or fibrosis in 39%. PCR for
M. leprae was positive in 47%
of the nerve biopsy samples (n=23). PCR, in conjunction with
clinical and neurological examination results, can be a powerful
tool in attempting to identify and confirm a PNL
diagnosis.