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Clinical prediction rules for the diagnosis of neuritis in leprosy.
Giesel, Louise Mara; Hökerberg, Yara Hahr Marques; Pitta, Izabela Jardim Rodrigues; Andrade, Lígia Rocha; Moraes, Debora Bartzen; da Costa Nery, José Augusto; Sarno, Euzenir Nunes; Jardim, Marcia Rodrigues.
Afiliação
  • Giesel LM; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21240-360, Brazil. louisegiesel@gmail.com.
  • Hökerberg YHM; Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil. louisegiesel@gmail.com.
  • Pitta IJR; Laboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious Diseases, Oswaldo Cruz, Brazil.
  • Andrade LR; School of Medicine, Estácio de Sá University, Rio de Janeiro, Brazil.
  • Moraes DB; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21240-360, Brazil.
  • da Costa Nery JA; Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
  • Sarno EN; Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Av. Brasil, 4365, Manguinhos, Rio de Janeiro, RJ, 21240-360, Brazil.
  • Jardim MR; Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
BMC Infect Dis ; 21(1): 858, 2021 Aug 23.
Article em En | MEDLINE | ID: mdl-34425777
BACKGROUND: Diagnosing neuritis in leprosy patients with neuropathic pain or chronic neuropathy remains challenging since no specific laboratory or neurophysiological marker is available. METHODS: In a cross-sectional study developed at a leprosy outpatient clinic in Rio de Janeiro, RJ, Brazil, 54 individuals complaining of neural pain (single or multiple sites) were classified into two groups ("neuropathic pain" or "neuritis") by a neurological specialist in leprosy based on anamnesis together with clinical and electrophysiological examinations. A neurologist, blind to the pain diagnoses, interviewed and examined the participants using a standardized form that included clinical predictors, pain features, and neurological symptoms. The association between the clinical predictors and pain classifications was evaluated via the Pearson Chi-Square or Fisher's exact test (p < 0.05). RESULTS: Six clinical algorithms were generated to evaluate sensitivity and specificity, with 95% confidence intervals, for clinical predictors statistically associated with neuritis. The most conclusive clinical algorithm was: pain onset at any time during the previous 90 days, or in association with the initiation of neurological symptoms during the prior 30-day period, necessarily associated with the worsening of pain upon movement and nerve palpation, with 94% of specificity and 35% of sensitivity. CONCLUSION: This algorithm could help physicians confirm neuritis in leprosy patients with neural pain, particularly in primary health care units with no access to neurologists or electrophysiological tests.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hanseníase / Neuralgia / Neurite (Inflamação) Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMC Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido
Texto completo
Adicionar na Minha BVS
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XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Hanseníase / Neuralgia / Neurite (Inflamação) Tipo de estudo: Clinical_trials / Diagnostic_studies / Observational_studies / Prevalence_studies / Prognostic_studies / Risk_factors_studies Limite: Humans País/Região como assunto: America do sul / Brasil Idioma: En Revista: BMC Infect Dis Assunto da revista: DOENCAS TRANSMISSIVEIS Ano de publicação: 2021 Tipo de documento: Article País de afiliação: Brasil País de publicação: Reino Unido