Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy.

Autor:	Penna PS; Universidade Federal do Estado do Rio de Janeiro, Programa de Pós-Graduação em Neurologia, Rio de Janeiro, RJ, Brasil., Pitta IJR; Universidade Federal do Estado do Rio de Janeiro, Programa de Pós-Graduação em Neurologia, Rio de Janeiro, RJ, Brasil.; Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Departamento de Hanseníase, Rio de Janeiro, RJ, Brasil.; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Vital RT; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil., Hacker MAVB; Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Departamento de Hanseníase, Rio de Janeiro, RJ, Brasil., Salles AM; Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Departamento de Hanseníase, Rio de Janeiro, RJ, Brasil., Pinheiro RO; Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Departamento de Hanseníase, Rio de Janeiro, RJ, Brasil., Antunes SLG; Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Departamento de Hanseníase, Rio de Janeiro, RJ, Brasil., Sarno EN; Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Departamento de Hanseníase, Rio de Janeiro, RJ, Brasil., Jardim MR; Universidade Federal do Estado do Rio de Janeiro, Programa de Pós-Graduação em Neurologia, Rio de Janeiro, RJ, Brasil.; Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Departamento de Hanseníase, Rio de Janeiro, RJ, Brasil.; Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.
Jazyk:	angličtina
Zdroj:	Memorias do Instituto Oswaldo Cruz [Mem Inst Oswaldo Cruz] 2023 Jan 16; Vol. 117, pp. e220150. Date of Electronic Publication: 2023 Jan 16 (Print Publication: 2023).
DOI:	10.1590/0074-02760220150
Abstrakt:	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.
Databáze:	MEDLINE
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