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Peripheral nerve biopsy: a tool still needed in the early diagnosis of neural leprosy?
Dos Santos, Diogo Fernandes; Antunes, Douglas Eulálio; Dornelas, Bruno Carvalho; da Cunha, Bruno Araujo; Oliveira, Thales Junqueira; Pereira, Raquel Campos; Goulart, Luiz Ricardo; Goulart, Isabela Maria Bernardes.
Afiliação
  • Dos Santos DF; National Reference Center for Sanitary Dermatology and Leprosy, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
  • Antunes DE; Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
  • Dornelas BC; National Reference Center for Sanitary Dermatology and Leprosy, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
  • da Cunha BA; Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
  • Oliveira TJ; National Reference Center for Sanitary Dermatology and Leprosy, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
  • Pereira RC; Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
  • Goulart LR; National Reference Center for Sanitary Dermatology and Leprosy, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
  • Goulart IMB; National Reference Center for Sanitary Dermatology and Leprosy, School of Medicine, Federal University of Uberlândia (UFU), 1720 Pará Avenue, Uberlândia, MG, 38400-902, Brazil.
Trans R Soc Trop Med Hyg ; 114(11): 792-797, 2020 11 06.
Article em En | MEDLINE | ID: mdl-32710545
BACKGROUND: The early recognition of neural impairment in leprosy, especially in primary neural forms, represents a challenge in clinical practice and a peripheral nerve biopsy may be required for diagnostic confirmation. This study aims to characterize the epidemiological, clinical, electroneuromyographic, laboratory and histopathological aspects of patients undergoing peripheral nerve biopsy during investigation of primary neural cases in leprosy. METHODS: A total of 104 patients with peripheral neuropathy who were referred to a national reference centre for leprosy were biopsied from 2014 to 2018. All cases underwent clinical, laboratory, histopathological and electroneuromyographic evaluations. RESULTS: Of 104 biopsied patients, leprosy was confirmed in 89.4% (93/104). The biopsied nerves were the ulnar (67.8% [63/93]), superficial fibular (21.5% [20/93]), sural (8.6% [8/93]), radial (1.1% [1/93]) and deep fibular (1.1% [1/93]). Twenty-nine percent (27/93) presented histopathological abnormalities and 4.4% (4/93) presented acid-fast bacilli. Nerve and superjacent skin quantitative polymerase chain reaction were positive in 49.5% (46/93) and 24.8% (23/93) of cases, respectively. Patients with multiple mononeuropathy had a higher frequency of histopathological abnormalities (p=0.0077). CONCLUSIONS: This study reinforces peripheral nerve biopsy's role as an important tool in the investigation of primary neural cases, contributing to the early diagnosis and also reducing diagnostic errors and the need for empirical treatment.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hanseníase Tuberculoide Tipo de estudo: Diagnostic_studies / Screening_studies Limite: Humans Idioma: En Revista: Trans R Soc Trop Med Hyg Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hanseníase Tuberculoide Tipo de estudo: Diagnostic_studies / Screening_studies Limite: Humans Idioma: En Revista: Trans R Soc Trop Med Hyg Ano de publicação: 2020 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido