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Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy

Penna, Patricia Sola ; Pitta, Izabela Jardim Rodrigues ; Vital, Robson Teixeira ; Hacker, Mariana Andrea Vilas Boas ; Salles, Ana Maria ; Pinheiro, Roberta Olmo ; Antunes, Sergio Luiz Gomes ; Sarno, Euzenir Nunes ; Jardim, Márcia Rodrigues

Memórias do Instituto Oswaldo Cruz, 2022-01, Vol.117, p.e220150 [Periódico revisado por pares]

Brazil: Instituto Oswaldo Cruz, Ministério da Saúde

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Título:
Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy
Autor: Penna, Patricia Sola ; Pitta, Izabela Jardim Rodrigues ; Vital, Robson Teixeira ; Hacker, Mariana Andrea Vilas Boas ; Salles, Ana Maria ; Pinheiro, Roberta Olmo ; Antunes, Sergio Luiz Gomes ; Sarno, Euzenir Nunes ; Jardim, Márcia Rodrigues
Assuntos: Drug Therapy, Combination ; Humans ; Leprostatic Agents - adverse effects ; Leprosy - pathology ; Leprosy, Lepromatous - complications ; Leprosy, Lepromatous - drug therapy ; Leprosy, Lepromatous - pathology ; PARASITOLOGY ; Peripheral Nervous System Diseases - etiology ; TROPICAL MEDICINE
É parte de: Memórias do Instituto Oswaldo Cruz, 2022-01, Vol.117, p.e220150
Descrição: 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. To evaluate the outcome of peripheral neuropathy in patients with lepromatous leprosy (LL) and persistent neuropathic symptoms years after completing MDT. We evaluated the medical records of 14 patients with LL who underwent nerve biopsies due to worsening neuropathy at least four years after MDT. 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. Patients with LL can develop progressive peripheral neuropathy, which continues to develop even when they are on long-term anti-inflammatory and immunosuppressive therapy.
Editor: Brazil: Instituto Oswaldo Cruz, Ministério da Saúde
Idioma: Inglês;Português

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Progressive neuropathy in patients with lepromatous leprosy after multidrug therapy

Penna, Patricia Sola ; Pitta, Izabela Jardim Rodrigues ; Vital, Robson Teixeira ; Hacker, Mariana Andrea Vilas Boas ; Salles, Ana Maria ; Pinheiro, Roberta Olmo ; Antunes, Sergio Luiz Gomes ; Sarno, Euzenir Nunes ; Jardim, Márcia Rodrigues

Brazil: Instituto Oswaldo Cruz, Ministério da Saúde

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