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1.
PLoS Negl Trop Dis ; 14(2): e0008030, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-32023242

RESUMO

BACKGROUND: Skin neglected tropical diseases (NTDs) such as Buruli ulcer (BU) and leprosy produce significant stigma and disability. Shared clinical presentations and needs for care present opportunities for integrated case management in co-endemic areas. As global policies are translated into local integrated services, there remains a need to monitor what new configurations of care emerge and how individuals experience them. METHODS: To explore patient experiences of integrated case management for skin NTDs, in 2018, we conducted a field-based qualitative case series in a leprosy rehabilitation centre in Ganta, Liberia where BU services were recently introduced. Twenty patients with BU (n = 10) and leprosy (n = 10) participated in in-depth interviews that incorporated photography methods. We contextualised our findings with field observations and unstructured interviews with health workers. FINDINGS: The integration of care for BU and leprosy prompted new conceptualisations of these diseases and experiences of NTD stigma. Some patients felt anxiety about using services because they feared being infected with the other disease. Other patients viewed the two diseases as 'intertwined': related manifestations of the same condition. Configurations of inter-disease stigma due to fear of transmission were buffered by joint health education sessions which also appeared to facilitate social support between patients in the facility. For both diseases, medication and wound care were viewed as the cornerstones of care and appreciated as interventions that led to rehabilitation of the whole patient group through shared experiences of healing, avoidance of physical deformities and stigma reduction. Patient accounts of intense pain during wound care for BU and inability of staff to manage severe complications, however, exposed some shortcomings of medical care for the newly integrated service, as did patient fears of long-lasting disability due to lack of physiotherapy services. SIGNIFICANCE: Under integrated care policies, the possibility of new discourses about skin NTD identities emerging along with new configurations of stigma may have unanticipated consequences for patients' experiences of case management. The social experience of integrated medication and wound dressing has the potential to link patients within a single, supportive patient community. Control programmes with resource constraints should anticipate potential challenges of integrating care, including the need to ameliorate lasting disability and provide adequate clinical management of severe BU cases.


Assuntos
Úlcera de Buruli/complicações , Úlcera de Buruli/epidemiologia , Administração de Caso , Hanseníase/complicações , Hanseníase/epidemiologia , Doenças Negligenciadas , Humanos , Libéria/epidemiologia , Estigma Social , Apoio Social , Clima Tropical , Medicina Tropical
2.
Artigo em Inglês | MEDLINE | ID: mdl-32074217

RESUMO

Tropical diseases are mainly found in the tropical regions of Asia, Africa and Latin America. They are a major Public Health problem in these regions, most of them are considered neglected diseases and remain as important contributors to the development of AKI (Acute Kidney Injury), which is associated with increased patients' morbidity and mortality. In most countries, kidney disease associated to tropical diseases is attended at health services with poor infrastructure and inadequate preventive measures. The long-term impacts of these infections on kidney tissue may be a main cause of future kidney disease in these patients. Therefore, the investigation of novel kidney injury biomarkers in these tropical diseases is of utmost importance to explain the mechanisms of kidney injury, to improve their diagnosis and prognosis, as well as the assessment to health systems by these patients. Since 2011, our group has been studying renal biomarkers in visceral and cutaneous leishmaniasis, schistosomiasis, leptospirosis and leprosy. This study has increased the knowledge on the pathophysiology of kidney disease in the presence of these infections and has contributed to the early diagnosis of kidney injury, pointing to glomerular, endothelial and inflammatory involvement as the main causes of the mechanisms leading to nephropathy and clinical complications. Future perspectives comprise establishing long-term cohort groups to assess the development of kidney disease and the patients' survival, as well as the use of new biomarkers such as urinary exosomes to detect risk groups and to understand the progression of kidney injuries.


Assuntos
Lesão Renal Aguda/etiologia , Leishmaniose Visceral/complicações , Hanseníase/complicações , Leptospirose/complicações , Doenças Negligenciadas/complicações , Esquistossomose/complicações , Dengue Grave/complicações , Lesão Renal Aguda/sangue , Biomarcadores/sangue , Humanos , Doenças Negligenciadas/sangue , Fatores de Risco
3.
Rev. bras. cir. plást ; 34(4): 497-503, oct.-dec. 2019. ilus, tab
Artigo em Inglês, Português | LILACS | ID: biblio-1047912

RESUMO

Introdução: A úlcera plantar por hanseníase é uma lesão no pé resultante da falta de sensibilidade plantar. O objetivo é descrever o tratamento realizado em portadores de úlceras plantares por hanseníase. Métodos: Estudo de prontuários de portadores de úlcera plantar atendidos no Hospital Sarah em Brasília, de 2006 a 2016, quanto ao sexo, idade, etiologia, localização e tratamento. Resultados: Foram atendidos 27 pacientes, 17(62,96%) homens e 10 (37,04%) mulheres, procedentes de Goiás e DF, na faixa etária de 41 a 60 anos (40,74%). Todos necessitaram de um ou mais procedimentos cirúrgicos. Conclusão: Observou-se maior frequência no sexo masculino, grau avançado, localizadas no primeiro artelho. Todos necessitaram de procedimentos cirúrgicos e não cirúrgicos, evoluindo com cicatrização completa da ferida, amputação transtibial em um caso e de artelhos em sete casos, e 90% dos casos apresentaram recorrência da úlcera após um ano.


Introduction: Leprosy-induced plantar ulcers result from a lack of plantar sensitivity. Objective: This study aimed to describe the treatment provided to patients with leprosy-induced plantar ulcers. Methods: We retrospectively reviewed the medical records of patients with plantar ulcers treated at Sarah Hospital in Brasilia from 2006 to 2016 and collected information about sex, age, etiology, location, and treatment. Results: A total of 27 patients (17 [62.96%] men, 10 [37.04%] women; 40.74% were aged 41­60 years) were treated from Goiás and the Federal District. All required ≥1 surgical procedure. Conclusion: A higher frequency of advanced grade was observed in men, primarily on the first toe. All needed surgical and non-surgical procedures and achieved complete wound healing. Transtibial amputation was required in 1 case and toe amputation in 7 cases; 90% patients developed ulcer recurrence after 1 year.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , História do Século XXI , Reabilitação , Terapêutica , Tratamento Terciário , Registros Médicos , Úlcera do Pé , Hanseníase , Reabilitação/métodos , Reabilitação/estatística & dados numéricos , Terapêutica/métodos , Terapêutica/estatística & dados numéricos , Tratamento Terciário/métodos , Tratamento Terciário/estatística & dados numéricos , Registros Médicos/normas , Registros Médicos/estatística & dados numéricos , Úlcera do Pé/cirurgia , Úlcera do Pé/complicações , Úlcera do Pé/terapia , Hanseníase/cirurgia , Hanseníase/complicações , Hanseníase/terapia
5.
Fisioter. Pesqui. (Online) ; 26(3): 247-257, jul.-set. 2019. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1039888

RESUMO

ABSTRACT The purpose of this study is to analyze the effects of using customized insoles and leg and foot exercises on the feet of patients with neuropathy caused by leprosy. Thirty volunteers diagnosed with leprosy were assigned to one of three groups: (1) Exercise group (n=10): performed exercises for the intrinsic muscles of the foot; (2) Insole group (n=10): used insoles to correct foot positioning; (3) Insole and Exercise group (n=10): used insoles and performed an exercise routine. The results of the treatments were analyzed with photogrammetry using the Alcimagem® and AutoCAD® programs. Left hindfoot posture changed after treatment in the Exercise and Insole groups (hindfoot, pre versus post <0.001). We also found that combining exercise and insoles did not alter the alignment of the feet during the study's evaluation period (customized insoles and exercises, pre versus post <0.05), which suggests that follow-up for more than four months may be needed. The left hindfoot's alignment can be changed with supervised exercises and the use of insoles.


RESUMO O objetivo deste estudo é analisar a influência do uso de palmilhas personalizadas e exercícios para perna e pés nos ângulos do antepé, retropé e arco plantar de pacientes com neuropatia causada por hanseníase. Trinta voluntários diagnosticados com hanseníase foram designados para um dos três grupos: (1) grupo exercício (n=10): realização de exercícios para pernas e pés; (2) grupo palmilha (n=10): utilização de palmilhas para corrigir o posicionamento do pé; (3) grupo palmilha e exercícios (n=10): uso de palmilhas associado a uma rotina de exercícios. O resultado dos tratamentos foi analisado por meio de fotogrametria, com os softwares Alcimagem e AutoCAD. A postura do retropé esquerdo foi modificada após o tratamento no "grupo exercício" e "grupo palmilha" (retropé, pré versus pós<0,001). Também foi observado que a combinação entre exercícios e palmilhas não alterou o alinhamento dos pés durante o período de avaliação do estudo (palmilha e exercícios, pré versus pós>0,05), o que sugere que o acompanhamento por mais de quatro meses pode ser necessário. Assim, o uso isolado de exercícios supervisionados ou de palmilhas altera o alinhamento do retropé, como aferido por fotogrametria.


RESUMEN El presente estudio tiene como objetivo analizar la influencia del uso de plantillas personalizadas y la práctica ejercicios de piernas y pies en los ángulos del antepié, del retropié y del arco plantar de pacientes con neuropatía debido a lepra. Treinta voluntarios diagnosticados con lepra fueron asignados a uno de estos tres grupos: (1) grupo de ejercicios (n=10): hacer ejercicios de piernas y pies; (2) grupo de plantillas (n=10): utilizar plantillas para corregir la posición del pie; (3) grupo de plantillas y ejercicios (n=10): utilizar plantillas asociadas con una rutina de ejercicios. Los resultados de los tratamientos se analizaron mediante fotogrametría, con los softwares Alcimagem y AutoCAD. La postura del retropié izquierdo se modificó tras el tratamiento en el "grupo de ejercicios" y en el "grupo de plantillas" (retropié, pre versus pos <0,001). También se observó que la combinación de ejercicios y plantillas no alteró la alineación del pie durante el período de evaluación del estudio (plantilla y ejercicios, pre versus pos >0,05), lo que sugiere que puede requerirse seguimiento durante más de cuatro meses. Por lo tanto, la práctica aislada de ejercicios supervisados o el uso de plantillas altera la alineación del retropié, medido por fotogrametría.


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Aparelhos Ortopédicos , Doenças do Sistema Nervoso Periférico/reabilitação , Terapia por Exercício , Fotogrametria , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Pé/etiologia , Doenças do Pé/reabilitação , Hanseníase/complicações
7.
Rev Soc Bras Med Trop ; 52: e20180540, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31340360

RESUMO

INTRODUCTION: Monitoring disability trends is required to evaluate leprosy elimination. We assessed the trends in disability indicators and its association with space in Alagoas, Brazil. METHODS: We conducted an ecological study in all leprosy cases from 2006 to 2016. Disability indicators were analyzed using the joinpoint regression model. RESULTS: The proportion of new cases with grade 2 disability at diagnosis ranged from 4.7% to 11.9% (annual percent change, 1.4; P= 0.7), while at discharge, it ranged from 0.0% to 12.3% (annual percent change, -21.8; P= 0.2). CONCLUSIONS: Disability indicators had a stable trend over the study period.


Assuntos
Pessoas com Deficiência/estatística & dados numéricos , Hanseníase/epidemiologia , Brasil/epidemiologia , Doenças Endêmicas/estatística & dados numéricos , Humanos , Hanseníase/complicações , Análise Espacial
8.
PLoS Negl Trop Dis ; 13(6): e0007495, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-31247040

RESUMO

INTRODUCTION: A high proportion of grade 2 disability (visible deformity) is indicative of delay in detection of leprosy and leprosy is one of the major causes of preventable disability. We conducted this study to determine the risk factors associated with disability (G2D and G1D) among adult new leprosy cases and to measure their strength of association. METHODS: A multi-centric case-control study was undertaken in five states of India i.e. Andhra Pradesh, Delhi, Gujarat, Maharashtra and West Bengal). Among new adult patients, cases were defined as those with disability (G2D and G1D) at the time of diagnosis and controls were defined as those without any disability (G0D). Delays were quantified based on patient recall across a timeline. Patient delay defined as the time period between first noticed symptom by the patient and the first visit to any health care provider (HCP); HCP delay defined as the time period between patient's first visit to any HCP and the confirmation of diagnosis of leprosy; and total delay defined as the sum of both patient and HCP delays. RESULTS: A total of 1400 new leprosy patients (700 G2D/G1D and 700 G0D) across five states were interviewed. Among G2D/G1D, the median patient delay was 8 months compared with 4 months among G0D. The median HCP delay was 2 months for G2D/G1D and 1 month for G0D. The median total delay was 14 months for G2D/G1D and 6.2 months for G0D; observed median difference between groups was statistically significant (p<0.001). When patient delay was more than 3 months, odds of G2D/G1D at diagnosis were 1.6 times higher compared to when patient delay was less than 3 months. When the HCP delay was more than one month, the odds of G2D/G1D were 1.4 times higher compared to when the HCP delay was less than one month. When the patient had multi-bacillary type leprosy the odds of G2D/G1D at the time of diagnosis was nine times higher compared to pauci-bacillary type leprosy. CONCLUSION: Patient delay is the major reason for risk of disability (G2D/G1D) among adult leprosy patients. A patient delay of more than 3 months from the notice of first symptom is a significant indicator for the disabilities among adult leprosy patients. Early case detection campaigns like active surveys in endemic spots should be done periodically as this can reduce delays and promote early diagnosis. Additionally, the program should lay greater emphasis on raising community awareness regarding the disease. Also, health care provider delay of more than 1 month have been significant risk factors for disability among adult leprosy cases. Hence, periodical capacitation of all HCPs including private practitioners would significantly contribute to reduce diagnostic delay and promote timely referral and early detection.


Assuntos
Diagnóstico Tardio/estatística & dados numéricos , Pessoas com Deficiência/estatística & dados numéricos , Hanseníase/complicações , Hanseníase/epidemiologia , Tempo para o Tratamento/estatística & dados numéricos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Feminino , Humanos , Índia/epidemiologia , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Fatores de Risco , Adulto Jovem
10.
Gut Liver ; 13(5): 549-556, 2019 09 15.
Artigo em Inglês | MEDLINE | ID: mdl-30970433

RESUMO

Background/Aims: Patients with Hansen's disease are the most vulnerable to hepatitis C. However, no data on the treatment efficacy of direct-acting antiviral agents (DAAs) are available in this group. Therefore, we elucidated the prevalence and clinical outcomes of hepatitis C in persons affected by leprosy in Sorokdo, Jeollanam-do, Korea. Methods: We retrospectively included 50 leprosy patients with positive hepatitis C virus (HCV) RNA test results (group A) hospitalized at the Sorokdo National Hospital from May 2016 to March 2018 and 73 patients with chronic hepatitis C who were treated with DAAs at the Chonnam National University Hospital (group B) from May 2016 to December 2017. Results: Overall, at the Sorokdo National Hospital, positive HCV antibody and HCV RNA rates were 18.4% and 11.0%, respectively. The mean participant age was 76.5±7 years, and 58% of participants were men. The genotypes were type 1b in 44% (22 out of 50) and type 2 in 56% (28 out of 50). Sustained virologic response was achieved at a rate of 95.5% (21/22) in genotype 1b and 92.9% (26/28) in genotype 2 patients. Ribavirin-induced hemolytic anemia occurred in 57.1% (16/28) of patients with genotype 2. Among these, 28.5% (8/28) received blood transfusions. Conclusions: Treatment efficacy was not different between the leprosy-affected population and the general population. However, severe ribavirin-induced hemolytic anemia requiring transfusion was present in 28.5% of genotype 2 patients. Therefore, we suggest ribavirin-free DAAs for the treatment of genotype 2 hepatitis C in leprosy-affected persons in the future.


Assuntos
Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Hanseníase/complicações , Idoso , Anemia Hemolítica/induzido quimicamente , Antivirais/efeitos adversos , Feminino , Genótipo , Hepatite C Crônica/complicações , Hepatite C Crônica/epidemiologia , Humanos , Hanseníase/epidemiologia , Masculino , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos , Ribavirina/administração & dosagem , Ribavirina/efeitos adversos , Resposta Viral Sustentada , Resultado do Tratamento
11.
J Eur Acad Dermatol Venereol ; 33(7): 1205-1213, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30945360

RESUMO

BACKGROUND: Leprosy or Hansen's disease is a chronic infection caused by Mycobacterium leprae (M. leprae) or Mycobacterium lepromatosis (M. lepromatosis). In Europe, most of the leprosy cases are imported. However, occasionally a case is diagnosed in one of the old endemic foci. Leprosy is often not suspected because it is no longer emphasized in the medical curricula. Attention shifted from leprosy to tuberculosis and human immunodeficiency virus infections in the late 20th century, whereby the WHO leprosy programme was toned down in the conviction that leprosy was all but eliminated. The result of unawareness is a harmful doctor's delay. MATERIAL AND METHODS: This paper focusses on clinical diagnosis, complications and treatment based on literature and experience. RESULTS: It mentions the value of laboratory tests in classification, follow-up and detection of relapses. It discusses the etiopathology. CONCLUSION: This is a position statement.


Assuntos
Hansenostáticos/uso terapêutico , Hanseníase/diagnóstico , Hanseníase/tratamento farmacológico , Quimioterapia Combinada , Humanos , Hanseníase/classificação , Hanseníase/complicações , Recidiva , Transtornos das Sensações/microbiologia
12.
Rev Soc Bras Med Trop ; 52: e20180172, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30994795

RESUMO

INTRODUCTION: American tegumentary leishmaniasis (ATL) and leprosy share common areas of prevalence, but reports of coinfection are scarce. METHODS: We report a series of 9 ATL-leprosy cases and discuss the association. An integrative diagram to analyze the clinico-immunological features of coinfection with both diseases. RESULTS: Nine patients with leishmaniasis (5 cutaneous, 3 mucocutaneous, 1 disseminated case) exhibited concurrent infection with distinct clinical forms of leprosy. Our diagram-based analysis evidenced a divergent clinico-immunological spectrum for each disease in 8 out of 9 cases. CONCLUSIONS: The spectrum of ATL-leprosy comorbidity suggests that the host has a specific immune response against each pathogen.


Assuntos
Coinfecção/imunologia , Leishmaniose Cutânea/imunologia , Hanseníase/imunologia , Células Th1/imunologia , Células Th2/imunologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Leishmaniose Cutânea/complicações , Hanseníase/complicações , Masculino , Pessoa de Meia-Idade
14.
Neurol Sci ; 40(7): 1371-1375, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30903414

RESUMO

INTRODUCTION: Leprosy is nowaday increasingly encountered in non-endemic countries. Nerve involvement is common. Swelling of the nerves may lead to entrapment neuropathy causing pain and neurological deficits. Delay in diagnosis and treatment may lead to loss of chance of improvement. Surgical decompression in conjunction with medical therapy allows relief of symptoms. METHODS: We present a retrospective series of 21 patients surgically treated in our center for leprosy entrapment neuropathy. We report presentation, treatment, and outcome at follow-up including a brief literature review. RESULTS: Twenty-one patients were treated for nerve entrapments in four different anatomical districts. We reported good clinical outcomes mainly in motor deficits but also in improvement of sensitive deficits and pain symptoms. We did not experience surgical complications. DISCUSSION: Although there is a lack of high-quality prospective studies comparing medical and surgical treatment of leprosy neuropathy, benefits of surgery are widely reported in series and case reports from endemic countries. There is scant literature from low-incidence countries even if leprosy incidence is nowaday increasing in these countries and will likelihood further increase in the future. Our results are in line with the literature presenting good outcomes after surgery. CONCLUSION: We believe that a precise knowledge of the pathology and its management is crucial also for physicians who work in low-incidence countries to maximize healing chances with timely diagnosis and treatment.


Assuntos
Hanseníase/complicações , Hanseníase/cirurgia , Síndromes de Compressão Nervosa/etiologia , Síndromes de Compressão Nervosa/cirurgia , Descompressão Cirúrgica , Feminino , Seguimentos , Humanos , Incidência , Itália/epidemiologia , Hanseníase/tratamento farmacológico , Hanseníase/epidemiologia , Masculino , Síndromes de Compressão Nervosa/tratamento farmacológico , Síndromes de Compressão Nervosa/epidemiologia , Estudos Retrospectivos , Resultado do Tratamento
17.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46381

RESUMO

“Hanseníase. Identificou. Tratou. Curou”. Lançamento de uma nova campanha de conscientização do Ministério da Saúde do Brasil sobre a doença.


Assuntos
Hanseníase/prevenção & controle , Hanseníase/complicações
19.
Ann Afr Med ; 18(1): 7-11, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30729926

RESUMO

Background: The study was conducted in three major leprosy referral hospitals in Northern Nigeria, which are NKST Rehabilitation Hospital, Benue State, Yadakunya Leprosy Hospital, Kano, and National Tuberculosis/Leprosy Training Hospital, Zaria. The main objective of the study was to investigate factors responsible for the occurrence of ulcers among leprosy patients reporting to the leprosy referral hospitals. Materials and Methods: An analytic study of case-control design was used, with patients having plantar ulcers as cases and those without as control. Semi-structured was administered to all cases and controls. Results: A total of 242 patients were studied; 124 patients (51.2%) had plantar ulcers whereas 118 (48.8%) had no ulcers (controls). A Chi-square test was used in the analysis to compare cases and controls. The study found differences between cases and controls with respect to patients release from treatment (RFT), gender, availability and utilization of footwear, age, occupation, and educational status. Footwears were provided to most patients, i.e. 60.8% late (i.e., after developing plantar ulcers); however, there was very good utilization of the footwears among those who had the footwears, 65.3%. Knowledge of self-care was higher among 64.5% of cases compared to only 28.1% of the controls. Conclusion: Ulcer still remains a major problem among leprosy patients, especially RFT (76.6%) and most cases are provided with footwear late. Self-care knowledge is higher among cases than controls.


Assuntos
Úlcera do Pé/epidemiologia , Hanseníase/complicações , Sapatos , Estudos de Casos e Controles , Feminino , Úlcera do Pé/prevenção & controle , Humanos , Masculino , Nigéria/epidemiologia , Autocuidado , Fatores Socioeconômicos , Inquéritos e Questionários
20.
Am J Trop Med Hyg ; 100(4): 921-931, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30761984

RESUMO

Neurotropism and infiltration by Mycobacterium leprae of peripheral nerves causing neuropathy are well established, but reports of central nervous system (CNS) damage are exceptional. We report CNS magnetic resonance imaging (MRI) abnormalities of the brain and spinal cord as well as lesions in nerve roots and plexus in leprosy patients. Eight patients aged between 17 and 41 years underwent detailed clinical, histopathological, and MRI evaluation. All had prominent sensory-motor deficits with hypopigmented and hypo/anesthetic skin patches and thickened peripheral nerves. All demonstrated M. Leprae DNA in affected peripheral nerve tissue. All received multidrug therapy (MDT). Two patients had brainstem lesions with enhancing facial nuclei and nerves, and one patient had a lesion in the nucleus ambiguus. Two patients had enhancing spinal cord lesions. Follow-up MRI performed in four cases showed resolution of brainstem and cord lesions after starting on MDT. Thickened brachial and lumbosacral plexus nerves were observed in six and two patients, respectively, which partially resolved on follow-up MRI in the two cases who had reimaging. The site and side of the MRI lesions corresponded with the location and side of neurological deficits. This precise clinico-radiological correlation of proximal lesions could be explained by an immune reaction in the gray matter corresponding to the involved peripheral nerves, retrograde axonal and gray matter changes, or infection of the CNS and plexus by lepra bacilli. Further study of the CNS in patients with leprous neuropathy is needed to establish the exact nature of these CNS MRI findings.


Assuntos
Encéfalo/diagnóstico por imagem , Hanseníase/complicações , Hanseníase/diagnóstico por imagem , Doenças da Medula Espinal/diagnóstico por imagem , Medula Espinal/patologia , Adolescente , Adulto , Encéfalo/microbiologia , Encéfalo/patologia , DNA Bacteriano/análise , Quimioterapia Combinada , Feminino , Humanos , Hansenostáticos/uso terapêutico , Hanseníase/tratamento farmacológico , Hanseníase/patologia , Imagem por Ressonância Magnética , Masculino , Mycobacterium leprae , Medula Espinal/diagnóstico por imagem , Medula Espinal/microbiologia , Doenças da Medula Espinal/microbiologia , Adulto Jovem
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