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The red flags of ulnar neuropathy in leprosy.
Jardim, Márcia; Vital, Robson T; Illarramendi, Ximena; Hacker, Mariana; Junqueira, Beatriz; Pitta, Izabela J R; Pinheiro, Roberta O; Sarno, Euzenir N.
Afiliación
  • Jardim M; Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
  • Vital RT; Department of Neurology, Pedro Ernesto University Hospital/Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Illarramendi X; Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
  • Hacker M; Department of Neurology, Pedro Ernesto University Hospital/Rio de Janeiro State University, Rio de Janeiro, Brazil.
  • Junqueira B; Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
  • Pitta IJR; Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
  • Pinheiro RO; Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
  • Sarno EN; Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, Brazil.
PLoS One ; 16(11): e0259804, 2021.
Article en En | MEDLINE | ID: mdl-34797866
The diagnosis of pure neural leprosy is more challenging because patients share characteristics with other common pathologies, such as ulnar compression, which should be taken into consideration for differential diagnosis. In this study, we identify ulnar nerve conduction characteristics to aid in the differential diagnosis of ulnar neuropathy (UN) in leprosy and that of non-leprosy etiology. In addition, we include putative markers to better understand the inflammatory process that may occur in the nerve. Data were extracted from a database of people affected by leprosy (leprosy group) diagnosed with UN at leprosy diagnosis. A non-leprosy group of patients diagnosed with mechanical neuropathy (compressive, traumatic) was also included. Both groups were submitted to clinical, neurological, neurophysiological and immunological studies. Nerve enlargement and sensory impairment were significantly higher in leprosy patients than in patients with compressive UN. Bilateral impairment was significantly higher in the leprosy group than in the non-leprosy group. Leprosy reactions were associated to focal demyelinating lesions at the elbow and to temporal dispersion (TD). Clinical signs such as sensory impairment, nerve enlargement and bilateral ulnar nerve injury associated with eletrodiagnostic criteria such as demyelinating finds, specifically temporal dispersion, could be tools to help us decided on the best conduct in patients with elbow ulnar neuropathy and specifically decide if we should perform a nerve biopsy for diagnosis of pure neural leprosy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuropatías Cubitales / Lepra Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2021 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neuropatías Cubitales / Lepra Tipo de estudio: Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Female / Humans / Male / Middle aged País/Región como asunto: America do sul / Brasil Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2021 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos