Author | Giesel, Louise Mara | |
Author | Hökerberg, Yara Hahr Marques | |
Author | Pitta, Izabela Jardim Rodrigues | |
Author | Andrade, Lígia Rocha | |
Author | Moraes, Debora Bartzen | |
Author | Nery, José Augusto da Costa | |
Author | Sarno, Euzenir Nunes | |
Author | Jardim, Marcia Rodrigues | |
Access date | 2021-11-04T23:41:37Z | |
Available date | 2021-11-04T23:41:37Z | |
Document date | 2021 | |
Citation | GIESEL, Louise Mara et al. Clinical prediction rules for the diagnosis of neuritis in leprosy. BMC Infectious Diseases, v. 21, n. 1, p. 1-9, 2021. | pt_BR |
ISSN | 1471-2334 | pt_BR |
URI | https://www.arca.fiocruz.br/handle/icict/49692 | |
Language | eng | pt_BR |
Publisher | BMC | pt_BR |
Rights | open access | pt_BR |
Title | Clinical prediction rules for the diagnosis of neuritis in leprosy | pt_BR |
Type | Article | pt_BR |
DOI | 10.1186/s12879-021-06545-2 | |
Abstract | 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. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Laboratório de Epidemiologia Clínica. Rio de Janeiro, RJ, Brasil / Universidade Estácio de Sá. Faculdade de Medicina. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil. | pt_BR |
Affilliation | Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Hanseníase. Rio de Janeiro, RJ, Brasil / Universidade Federal do Estado do Rio de Janeiro. Programa de Pós-Graduação em Neurologia. Rio de Janeiro, RJ, Brasil / Universidade do Estado do Rio de Janeiro. Hospital Universitário Pedro Ernesto. Departamento de Neurologia. Rio de Janeiro, RJ, Brasil. | pt_BR |
Subject | Clinical prediction rules | pt_BR |
Subject | Leprosy | pt_BR |
Subject | Neuritis | pt_BR |
Subject | Neuropathic pain | pt_BR |
Subject | Sensitivity | pt_BR |
Subject | Specificity | pt_BR |