Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases

Leprosy is one of the most common diseases of the peripheral nerves. In some cases there is only neural involvement without skin changes (neuritic form). The neuropathy has often a distal stocking and glove distribution with thermal and pinprick anesthesia and preservation of proprioception. There i...

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Main Authors: Marcos R.G. de Freitas, Osvaldo J.M. Nascimento, Ernestina A.M. Quaglino, Andréia Oliveira, Myrian D. Hahn
Format: Article
Language:English
Published: Thieme Revinter Publicações 2003-09-01
Series:Arquivos de Neuro-Psiquiatria
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Online Access:http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2003000400003&tlng=en
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author Marcos R.G. de Freitas
Osvaldo J.M. Nascimento
Ernestina A.M. Quaglino
Andréia Oliveira
Myrian D. Hahn
author_facet Marcos R.G. de Freitas
Osvaldo J.M. Nascimento
Ernestina A.M. Quaglino
Andréia Oliveira
Myrian D. Hahn
author_sort Marcos R.G. de Freitas
collection DOAJ
description Leprosy is one of the most common diseases of the peripheral nerves. In some cases there is only neural involvement without skin changes (neuritic form). The neuropathy has often a distal stocking and glove distribution with thermal and pinprick anesthesia and preservation of proprioception. There is no weakness, the tendon reflexes may be preserved and sometimes the nerves are thickened. We reported 17 patients with a predominantly small-fiber polyneuropathy due to leprosy. All patients had distal temperature and pain anesthesia with different individual variations. The tendon reflexes were normal in seven patients and in eight there was thickening of the nerves. The nerve conduction was normal in three patients. Sural nerve biopsy consisted of: 1) inflammatory infiltrates, 2) vacuolated "foamy" cells, 3) fibrosis of endoneurium, perineurium, and epineurium, 4) partial or total loss of nerve fibers, 5) large number of bacilli. We concluded that in countries where leprosy is frequent, nerve biopsy is an obligatory procedure in patients with predominantly small-fiber polyneuropathy.
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institution Kabale University
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publishDate 2003-09-01
publisher Thieme Revinter Publicações
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series Arquivos de Neuro-Psiquiatria
spelling doaj-art-19f3d44d239a4f09a8a4917880be77d82025-08-20T03:54:21ZengThieme Revinter PublicaçõesArquivos de Neuro-Psiquiatria1678-42272003-09-01613A54254610.1590/S0004-282X2003000400003Small-fiber polyneuropathy in leprosy without skin changes: study of 17 casesMarcos R.G. de Freitas0Osvaldo J.M. Nascimento1Ernestina A.M. Quaglino2Andréia Oliveira3Myrian D. Hahn4Universidade Federal FluminenseUniversidade Federal FluminenseUniversidade Federal FluminenseUniversidade Federal FluminenseUniversidade Federal FluminenseLeprosy is one of the most common diseases of the peripheral nerves. In some cases there is only neural involvement without skin changes (neuritic form). The neuropathy has often a distal stocking and glove distribution with thermal and pinprick anesthesia and preservation of proprioception. There is no weakness, the tendon reflexes may be preserved and sometimes the nerves are thickened. We reported 17 patients with a predominantly small-fiber polyneuropathy due to leprosy. All patients had distal temperature and pain anesthesia with different individual variations. The tendon reflexes were normal in seven patients and in eight there was thickening of the nerves. The nerve conduction was normal in three patients. Sural nerve biopsy consisted of: 1) inflammatory infiltrates, 2) vacuolated "foamy" cells, 3) fibrosis of endoneurium, perineurium, and epineurium, 4) partial or total loss of nerve fibers, 5) large number of bacilli. We concluded that in countries where leprosy is frequent, nerve biopsy is an obligatory procedure in patients with predominantly small-fiber polyneuropathy.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2003000400003&tlng=enleprosypure neuritic leprosysmall-fiber polyneuropathyperipheral neuropathynerve biopsy
spellingShingle Marcos R.G. de Freitas
Osvaldo J.M. Nascimento
Ernestina A.M. Quaglino
Andréia Oliveira
Myrian D. Hahn
Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases
Arquivos de Neuro-Psiquiatria
leprosy
pure neuritic leprosy
small-fiber polyneuropathy
peripheral neuropathy
nerve biopsy
title Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases
title_full Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases
title_fullStr Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases
title_full_unstemmed Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases
title_short Small-fiber polyneuropathy in leprosy without skin changes: study of 17 cases
title_sort small fiber polyneuropathy in leprosy without skin changes study of 17 cases
topic leprosy
pure neuritic leprosy
small-fiber polyneuropathy
peripheral neuropathy
nerve biopsy
url http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2003000400003&tlng=en
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