Author | Penna, Patricia Sola | |
Author | Pitta, Izabela Jardim Rodrigues | |
Author | Vital, Robson Teixeira | |
Author | Hacker, Mariana Andrea Vilas Boas | |
Author | Salles, Ana Maria | |
Author | Pinheiro, Roberta Olmo | |
Author | Antunes, Sergio Luiz Gomes | |
Author | Sarno, Euzenir Nunes | |
Author | Jardim, Márcia Rodrigues | |
Access date | 2023-03-02T17:57:23Z | |
Available date | 2023-03-02T17:57:23Z | |
Document date | 2022 | |
Citation | PENNA, Patricia Sola et al. Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy. Memórias do Instituto Oswaldo Cruz, Rio de Janeiro, v. 117:e220150, p. 1 - 5, Nov. 2022. | en_US |
ISSN | 0074-0206 | en_US |
URI | https://www.arca.fiocruz.br/handle/icict/57175 | |
Language | eng | en_US |
Publisher | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. | en_US |
Rights | open access | |
Subject in Portuguese | Lepra lepromatosa | en_US |
Subject in Portuguese | Neuropatia periférica | en_US |
Subject in Portuguese | Mecanismos fisiopatológicos | en_US |
Subject in Portuguese | Resultado a longo prazo | en_US |
Title | Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy | en_US |
Type | Article | en_US |
DOI | 10.1590/0074-02760220150 | |
Abstract | BACKGROUND The lepromatous pole is a stigmatising prototype for patients with leprosy. Generally, these patients have little or
no symptoms of peripheral nerve involvement at the time of their diagnosis. However, signs of advanced peripheral neuropathy
would be visible during the initial neurological evaluation and could worsen during and after multidrug therapy (MDT).
Disabilities caused by peripheral nerve injuries greatly affect these patients’ lives, and the pathophysiological mechanisms
underlying nerve damage remain unclear.
OBJECTIVES To evaluate the outcome of peripheral neuropathy in patients with lepromatous leprosy (LL) and persistent
neuropathic symptoms years after completing MDT.
METHODS We evaluated the medical records of 14 patients with LL who underwent nerve biopsies due to worsening neuropathy
at least four years after MDT.
FINDINGS Neuropathic pain developed in 64.3% of the patients, and a neurological examination showed that most patients had
alterations in the medium- and large-caliber fibers at the beginning of treatment. Neurological symptoms and signs deteriorated
despite complete MDT and prednisone or thalidomide use for years. Nerve conduction studies showed that sensory nerves were
the most affected.
MAIN CONCLUSIONS Patients with LL can develop progressive peripheral neuropathy, which continues to develop even when
they are on long-term anti-inflammatory and immunosuppressive therapy. | en_US |
Affilliation | Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Hanseníase. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Hanseníase. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Hanseníase. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Hanseníase. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Hanseníase. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Hanseníase. Rio de Janeiro, RJ, Brasil. | en_US |
Affilliation | Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil / Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Departamento de Hanseníase. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil. | en_US |
Subject | Lepromatous leprosy | en_US |
Subject | Peripheral neuropathy | en_US |
Subject | Pathophysiological mechanisms | en_US |
Subject | Long-term outcome | en_US |