High-resolution ultrasonography for early diagnosis of neural impairment in seropositive leprosy household contacts.

Autor:	Luppi AM; National Reference Center for Sanitary Dermatology and Leprosy, Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Uberlândia, MG, Brazil.; Radiology Division, Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Uberlândia, MG, Brazil.; Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil., Ferreira GE; Radiology Division, Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Uberlândia, MG, Brazil., Prudêncio DL; National Reference Center for Sanitary Dermatology and Leprosy, Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Uberlândia, MG, Brazil., Antunes DE; National Reference Center for Sanitary Dermatology and Leprosy, Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Uberlândia, MG, Brazil.; Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil., Araújo L; Department of Mathematics, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil., Dos Santos DF; National Reference Center for Sanitary Dermatology and Leprosy, Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Uberlândia, MG, Brazil.; Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil., Nogueira-Barbosa MH; Department of Medical Imaging, Hematology and Clinical Oncology, Radiology Division, Ribeirão Preto Medical School, University of São Paulo Ribeirão Preto, São Paulo, Brazil., Goulart IMB; National Reference Center for Sanitary Dermatology and Leprosy, Clinics' Hospital, Federal University of Uberlândia (UFU/EBSERH), Uberlândia, MG, Brazil.; Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, MG, Brazil.
Jazyk:	angličtina
Zdroj:	PloS one [PLoS One] 2023 May 23; Vol. 18 (5), pp. e0285450. Date of Electronic Publication: 2023 May 23 (Print Publication: 2023).
DOI:	10.1371/journal.pone.0285450
Abstrakt:	Leprosy household contacts (HC) represent a high-risk group for the development of the disease. Anti-PGL-I IgM seropositivity also increases the risk of illness. Despite significant advances in leprosy control, it remains a public health problem; and early diagnosis of this peripheral neuropathy represents one of the main goals of leprosy programs. The present study was performed to identify neural impairment in leprosy HC by analyzing differences in high-resolution ultrasonographic (US) measurements of peripheral nerves between leprosy HC and healthy volunteers (HV). Seventy-nine seropositive household contacts (SPHC) and 30 seronegative household contacts (SNHC) underwent dermato-neurological examination and molecular analysis, followed by high-resolution US evaluation of cross-sectional areas (CSAs) of the median, ulnar, common fibular and tibial nerves. In addition, 53 HV underwent similar US measurements. The US evaluation detected neural thickening in 26.5% (13/49) of the SPHC and only in 3.3% (1/30) among the SNHC (p = 0.0038). The CSA values of the common fibular and tibial nerves were significantly higher in SPHC. This group also had significantly greater asymmetry in the common fibular and tibial nerves (proximal to the tunnel). SPHC presented a 10.5-fold higher chance of neural impairment (p = 0.0311). On the contrary, the presence of at least one scar from the BCG vaccine conferred 5.2-fold greater protection against neural involvement detected by US (p = 0.0184). Our findings demonstrated a higher prevalence of neural thickening in SPHC and support the role of high-resolution US in the early diagnosis of leprosy neuropathy. The combination of positive anti-PGL-I serology and absence of a BCG scar can identify individuals with greater chances of developing leprosy neuropathy, who should be referred for US examination, reinforcing the importance of including serological and imaging methods in the epidemiological surveillance of leprosy HC. Competing Interests: The authors have declared that no competing interests exist. (Copyright: © 2023 Luppi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)
Databáze:	MEDLINE
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