Article
Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil
Registro en:
PITTA, Izabela Jardim Rodrigues et al. Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil. Frontiers in Medicine, v. 9, Article 865485, p. 1 - 6, Mar. 2022.
2298-858X
10.3389/fmed.2022.865485
Autor
Pitta, Izabela Jardim Rodrigues
Hacker, Mariana Andrea
Vital, Robson Teixeira
Andrade, Ligia Rocha
Spitz, Clarissa Neves
Sales, Anna Maria
Antunes, Sergio Luiz Gomes
Sarno, Euzenir Nunes
Jardim, Marcia Rodrigues
Resumen
Introduction: Leprosy reactions are complications that can occur before, during, or after
multidrug therapy (MDT) and are considered a major cause of nerve damage. Neuritis is
an inflammatory process that causes nerve function impairment associated with pain and
tenderness along the nerve. Neuritis can be found in both type 1 and type 2 reactions
and may also be the sole manifestation of a leprosy reaction. The objective of this study
is to describe the incidence of leprosy reactions and its association with neuropathic pain
in pure neural leprosy (PNL) patients.
Methods: We selected 52 patients diagnosed with PNL and 67 patients with other
clinical forms of leprosy. During the MDT the patients visited the clinic monthly to take
their supervised dose. The patients were instructed to return immediately if any new
neurological deficit or skin lesions occurred during or after the MDT.
Results: Of the PNL patients, 23.1% had a leprosy reaction during or after the MDT,
while this was 59.7% for patients with the other clinical forms of leprosy. There was an
association between having PNL and not having any reaction during and after the MDT,
as well as having PNL and having neuritis after the MDT.There was also an association
between having previous neuritis and having neuropathic pain in the other clinical forms
of leprosy group, although this association was not present in the PNL group.
Discussion: Our data suggest that PNL is a different form of the disease, which
is immunologically more stable. In addition, PNL patients have more neuritis than the
classical leprosy skin reactions. In PNL there was no association between acute neuritis
and neuropathic pain, suggesting that these patients may have had silent neuritis.
Understanding and identifying neuritis is essential to reduce disability and the impact
on public health.
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