Assuntos
Granuloma/patologia , Hanseníase/diagnóstico , Sarcoidose/complicações , Dermatopatias/patologia , Biópsia , Diagnóstico Diferencial , Humanos , Inflamação/complicações , Inflamação/patologia , Hanseníase/patologia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/patologia , Reação em Cadeia da Polimerase , Prognóstico , Sarcoidose/diagnóstico , Sarcoidose/patologia , Pele/inervação , Pele/patologiaRESUMO
The developing world is still endemic to rabies, tetanus, leprosy, and malaria. Globally more than 55000 people die of rabies each year, about 95% in Asia and Africa. Annually, more than 10 million people, mostly in Asia, receive postexposure vaccination against the disease. World Health Organization estimated tetanus-related deaths at 163000 in 2004 worldwide. Globally, the annual detection of new cases of leprosy continues to decline and the global case detection declined by 3.54% during 2008 compared to 2007. Malaria is endemic in most countries, except the US, Canada, Europe, and Russia. Malaria accounts for 1.5-2.7 million deaths annually. Much of the disease burden related to these four infections is preventable.
Assuntos
Hanseníase/complicações , Malária/complicações , Doenças do Sistema Nervoso/etiologia , Raiva/complicações , Tétano/complicações , Animais , Antibacterianos/uso terapêutico , Antimaláricos/uso terapêutico , Antivirais/uso terapêutico , Humanos , Hanseníase/diagnóstico , Hanseníase/patologia , Hanseníase/terapia , Malária/diagnóstico , Malária/patologia , Malária/terapia , Malária Cerebral/diagnóstico , Malária Cerebral/patologia , Malária Cerebral/terapia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/patologia , Doenças do Sistema Nervoso/terapia , Raiva/diagnóstico , Raiva/patologia , Raiva/terapia , Tétano/diagnóstico , Tétano/patologia , Tétano/terapiaRESUMO
Hans Schliack (1919 -2008) was one of the prominent post war neurologists who acted successfully for the emancipation of clinical neurology in the former western part of Berlin and Germany. His scientific work was destined to the theory of segments (dermatomes, myotomes, zones of Head, initially with Karl Hansen in Lübeck), sweat disturbances in neurological disorders and peripheral nerve lesions. The latter issue led - in cooperation with Marco Mumenthaler - to the textbook, which held its leading standard since its first edition in 1965. Schliack's founding editorship of the purely neurological journal "Aktuelle Neurologie" since 1974, his author- and editorship of neurological textbooks and his teaching of numerous coworkers in Berlin and Hannover stress his outstanding role over nearly five decades.
Assuntos
Neurologia/história , Psiquiatria/história , Alemanha , Alemanha Ocidental , História do Século XX , História do Século XXI , Humanos , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/patologia , Doenças do Sistema Nervoso/terapia , Doenças Neuromusculares/diagnóstico , Doenças Neuromusculares/patologia , Publicações Periódicas como Assunto , Nervos Periféricos/patologiaRESUMO
Leprosy is one of the most ancient diseases recognized in the history of man. It has been progressively eradicated from many countries. However, the disease remains a major problem of public health in a dozen of countries where it still represents an archetype of the tropical infectious pathology.
Assuntos
Hanseníase Virchowiana/patologia , Hanseníase/complicações , Doenças do Sistema Nervoso/patologia , Humanos , Incidência , Hanseníase/terapia , Hanseníase/transmissão , Saúde Pública , Índice de Gravidade de Doença , Medicina TropicalRESUMO
Nerve granulomas occur at all points across the leprosy spectrum. Studies have been made using experimental models in which mycobacteria were injected directly in the sciatic or posterior tibial nerve of the guinea pig. Clinical and electrophysiological studies demonstrated axonal damage which was confirmed by morphometric studies showing disrupted myelin sheaths and in places complete demyelination. Further immunohistological studies showed a complete disappearance of staining for certain neuropeptides. The role of Schwann cells has also been investigated. Schwann cells in nerves affected by mycobacterial granulomas, both experimental and in leprosy patients were not demonstrated to be MHC class II positive suggesting that they did not play a role in antigen presentation. Macrophages in leprosy granulomas were shown to contain TNF alpha, suggesting that this cytokine played a role in axonal damage. The role of mycobacterial heat-shock protein in nerve granulomas has not as yet been determined. The localized nature of granulomas in leprosy nerves and nerves with experimental mycobacterial granulomas has been studied by a process of excision and repair with muscle grafts. Marked recovery has been demonstrated by clinical, electrophysiological, morphometric and immuno-histochemical techniques, the latter demonstrating a return of neuropeptide production.
Assuntos
Hanseníase/patologia , Mycobacterium leprae , Doenças do Sistema Nervoso/patologia , Animais , Citocinas/imunologia , Granuloma/imunologia , Granuloma/microbiologia , Granuloma/patologia , Proteínas de Choque Térmico/imunologia , Humanos , Hanseníase/imunologia , Hanseníase/microbiologia , Hanseníase/cirurgia , Bainha de Mielina/patologia , Células de Schwann/imunologia , Células de Schwann/microbiologiaRESUMO
26 Patients of leprosy presenting with hypopigmented lesions were divided on morphological grounds into 3 Sub groups, Group I (9 patients) with well-defined single patch with moderate to complete sensory loss; Group II (8 patients) with single ill-defined lesion having partial sensory loss; and Group III (9 patients) having multiple hypo-pigmented patches with mild to moderate sensory loss. Epidermal atrophy was a conspicuous histological finding in all groups. Only patients in Group I showed epitheloid cells in dermal infiltrate with erosion of epidermis in one case. This group may be labelled as maculoanesthetic leprosy. Patients in Group II and III showed mononuclear cell infiltrate in dermis, around neurovascular bundles and appendages. They were histologically consistent with indeterminate leprosy. Follow-up biopsy after six to eight months of treatment showed healing of the lesion of reduction in the infiltrate in most cases.
Assuntos
Epiderme/patologia , Hanseníase Tuberculoide/patologia , Hanseníase/patologia , Adolescente , Adulto , Atrofia , Criança , Feminino , Seguimentos , Humanos , Antígeno de Mitsuda , Masculino , Doenças do Sistema Nervoso/patologia , Transtornos da Pigmentação/patologia , SensaçãoRESUMO
A case of healed tuberculoid leprosy (TT) with multiple superficial nerve abscesses involving the whole cutaneous network on the patch is reported. To the best of our knowledge multiple cutaneous nerve abscesses involving the entire subcutaneous plexus on a TT patch is a very uncommon observation.
Assuntos
Abscesso/patologia , Hanseníase Tuberculoide/patologia , Doenças do Sistema Nervoso/patologia , Pele/inervação , Dapsona/uso terapêutico , Humanos , Índia , Hanseníase Tuberculoide/tratamento farmacológico , Masculino , Pessoa de Meia-IdadeRESUMO
A guinea pig model of nerve damage in leprosy has been used to investigate the expression of major histocompatibility complex (MHC) class II antigens in granulomatous lesions in nerves. Using an immunoelectronmicroscopical technique, infiltrating mononuclear cells and endoneural fibroblast-like cells are shown to be class II-positive in the experimental neural lesions. Schwann cells are not class II-positive under these conditions, although at the light microscope level Schwann cell-like cells appear to be positively stained. This illustrates the value of immunoelectronmicroscopy in the investigation of cell surface proteins in situ as compared with conventional light immunohistochemistry.
Assuntos
Granuloma/imunologia , Antígenos de Histocompatibilidade Classe II/imunologia , Infecções por Mycobacterium/imunologia , Nervo Isquiático/imunologia , Animais , Feminino , Granuloma/patologia , Cobaias , Imuno-Histoquímica , Microscopia Eletrônica , Infecções por Mycobacterium/patologia , Doenças do Sistema Nervoso/imunologia , Doenças do Sistema Nervoso/patologia , Nervo Isquiático/ultraestruturaRESUMO
Biopsies of 42 concurrent nerve and skin lesions across the spectrum of leprosy were classified and compared histologically and bacteriologically. Observations were made as follows: a) The bacterial load was higher in nerve than in skin lesions of the same histological classification, and it was higher in nerve than in concurrent skin lesions irrespective of classification, although not at the lepromatous pole. b) There was some discrepancy between the histological classification of nerve and skin lesions in half the cases. Skin classification appeared to represent the general tissue response and, insofar as discrepancies existed, the skin classification was thought to give the better evaluation. Nerve classification was subject to minor variations of a random nature which were thought to be the outcome of local reactions due to the build up of antigen as a result of delayed recognition in an immunologically protected situation. Upgrading or downgrading ensued locally, depending on the level of antigen at the time of its detection. In such cases, the corresponding skin classification was usually BT, which occupied a critical point in the spectrum. A certain autonomy of the response between lesions of skin and nerve suggests an explanation for downgrading reactions. Although Mycobacterium leprae, alone among mycobacteria, has some sort of affinity for Schwann cells, it is the role of the nerves as protected sites which is fundamental to the course of the disease.
Assuntos
Hanseníase/patologia , Mycobacterium leprae/isolamento & purificação , Doenças do Sistema Nervoso/patologia , Neurônios/patologia , Biópsia , Humanos , Hanseníase/complicações , Hanseníase/microbiologia , Doenças do Sistema Nervoso/complicações , Doenças do Sistema Nervoso/microbiologia , Neurônios/microbiologia , Pele/microbiologia , Pele/patologiaAssuntos
Hanseníase/microbiologia , Macrófagos/microbiologia , Mycobacterium leprae/isolamento & purificação , Fibras Nervosas/ultraestrutura , Doenças do Sistema Nervoso/microbiologia , Animais , Axônios/ultraestrutura , Humanos , Hanseníase/patologia , Macrófagos/ultraestrutura , Camundongos , Microscopia Eletrônica , Bainha de Mielina/ultraestrutura , Fibras Nervosas Mielinizadas , Doenças do Sistema Nervoso/patologia , Nervo Radial/transplante , Células de Schwann/microbiologia , Células de Schwann/ultraestrutura , Nervo Isquiático/microbiologia , Nervo Isquiático/ultraestrutura , Fatores de Tempo , Transplante Heterólogo , Nervo Ulnar/transplanteAssuntos
Hanseníase/diagnóstico , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium/diagnóstico , Doenças do Sistema Nervoso/diagnóstico , Neurofibroma/diagnóstico , Neoplasias do Sistema Nervoso Periférico/diagnóstico , Adulto , Braço/inervação , Diagnóstico Diferencial , Humanos , Hanseníase/patologia , Masculino , Infecções por Mycobacterium não Tuberculosas/patologia , Doenças do Sistema Nervoso/patologiaAssuntos
Hanseníase/complicações , Doenças do Sistema Nervoso/etiologia , Corticosteroides/uso terapêutico , Diagnóstico Diferencial , Humanos , Terapia de Imunossupressão , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso/tratamento farmacológico , Doenças do Sistema Nervoso/patologiaRESUMO
Nerve damage in non-lepromatous leprosy and in "reversal" reactions is the result of an immune response to the presence of antigenic material derived from leprosy bacilli within nerves.