Assuntos
Neurite do Plexo Braquial/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Hanseníase Virchowiana/diagnóstico , Doenças do Sistema Nervoso Periférico/diagnóstico , Sarcoidose/diagnóstico por imagem , Doenças da Esclera/diagnóstico por imagem , Adulto , Atrofia , Neurite do Plexo Braquial/etiologia , Córtex Cerebral/patologia , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças do Sistema Nervoso Periférico/etiologia , Sarcoidose/complicações , Sarcoidose/patologia , Doenças da Esclera/etiologiaRESUMO
Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae , clinically present either as tuberculoid, borderline or lepromatous type. Erythema nodosum leprosum (ENL) is an acute humoral response in the chronic course of lepromatous leprosy. Although very severe ENL reactions are known in systemic leprosy, such severity is rare in ocular tissues. A leprosy uveitis patient suffered from a severe form of post-therapeutic ENL reaction which resulted in perforation of the globe at the site of preexisting subconjunctival leproma. Painful blind eye was enucleated. Histopathological study revealed infiltration of numerous polymorphs and macrophages packed with acid-fast bacilli in the conjunctiva, cornea, ciliary body, ora serrata and sclera. A profuse influx of neutrophils on a background of macrophages packed with M. leprae confirmed the ocular ENL reaction. This case is reported to alert the ophthalmologists to a rare ocular complication of ENL.
Assuntos
Antibacterianos/uso terapêutico , Eritema Nodoso/tratamento farmacológico , Infecções Oculares Bacterianas/tratamento farmacológico , Hanseníase Virchowiana/tratamento farmacológico , Esclera/patologia , Doenças da Esclera/patologia , Adulto , Eritema Nodoso/complicações , Eritema Nodoso/patologia , Infecções Oculares Bacterianas/complicações , Infecções Oculares Bacterianas/patologia , Seguimentos , Humanos , Hanseníase Virchowiana/complicações , Hanseníase Virchowiana/patologia , Masculino , Ruptura Espontânea , Doenças da Esclera/etiologia , Índice de Gravidade de DoençaRESUMO
This study is based upon the observation f 363 leprosy patients having different types of the disease. At the time of the examination, we did not have any previous knowledge about the type of leprosy the patients were having. Thus, the eye examination was done without the knowledge of clinical diagnosis. The ocular examination protocol covered the following: visual activity, facial muscle function, eyebrows, eyelashes, lacrimal system, pupil, eye motility, corneal sensitivity, Schirmir's test and study of the anterior segment of the ocular bulb with a slit-lamp. The study patients included 275 cases of lepromatous leprosy, 57 tuberculoid, 29 indeterminate and two dimorphous cases. The age of the patients ranged between 18 and 82 years, and 229 of them were males. Among those patients, 183 were whites, 23 were black and 157 were mulatto.