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Leprosy and the peripheral nervous system: basic and clinical aspects.
Muscle Nerve. 2004 Oct; 30(4):393-409.MN

Abstract

Leprosy is one of the most common causes of nontraumatic peripheral neuropathy in the developing world. The causative agent, Mycobacterium leprae, has a predilection for Schwann cells, where the organism multiplies unimpeded by organism-specific host immunity, resulting in destruction of myelin, secondary inflammatory changes, and destruction of the nerve architecture. The cardinal diagnostic features of leprosy are anesthetic skin lesions, neuropathy, and positive skin smears for the bacilli. However, patients may rarely present without skin lesions in pure neuritic leprosy. Electrodiagnostic findings early in the disease reveal demyelinating features, such as slowing of conduction velocity and prolongation of latencies, but as the disease progresses secondary axonal damage commonly ensues. Electrodiagnostic studies are also useful to monitor for toxicity secondary to therapy, particularly thalidomide-associated neuropathy. Nerve biopsy of a sensory cutaneous nerve is sometimes essential to confirm a diagnosis of leprosy. Significant advances in understanding of the pathogenesis, mapping of the genome, and other advances in molecular biology may result in better preventive and therapeutic modalities, and the goal of eradicating leprosy as a global problem may yet be realized.

Authors+Show Affiliations

Department of Infectious Disease, Lahey Clinic, 41 Mall Road, Burlington, Massachusetts 01805, USA. winnie.w.ooi@lahey.orgNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15372437

Citation

Ooi, Winnie W., and Jayashri Srinivasan. "Leprosy and the Peripheral Nervous System: Basic and Clinical Aspects." Muscle & Nerve, vol. 30, no. 4, 2004, pp. 393-409.
Ooi WW, Srinivasan J. Leprosy and the peripheral nervous system: basic and clinical aspects. Muscle Nerve. 2004;30(4):393-409.
Ooi, W. W., & Srinivasan, J. (2004). Leprosy and the peripheral nervous system: basic and clinical aspects. Muscle & Nerve, 30(4), 393-409.
Ooi WW, Srinivasan J. Leprosy and the Peripheral Nervous System: Basic and Clinical Aspects. Muscle Nerve. 2004;30(4):393-409. PubMed PMID: 15372437.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Leprosy and the peripheral nervous system: basic and clinical aspects. AU - Ooi,Winnie W, AU - Srinivasan,Jayashri, PY - 2004/9/17/pubmed PY - 2004/10/27/medline PY - 2004/9/17/entrez SP - 393 EP - 409 JF - Muscle & nerve JO - Muscle Nerve VL - 30 IS - 4 N2 - Leprosy is one of the most common causes of nontraumatic peripheral neuropathy in the developing world. The causative agent, Mycobacterium leprae, has a predilection for Schwann cells, where the organism multiplies unimpeded by organism-specific host immunity, resulting in destruction of myelin, secondary inflammatory changes, and destruction of the nerve architecture. The cardinal diagnostic features of leprosy are anesthetic skin lesions, neuropathy, and positive skin smears for the bacilli. However, patients may rarely present without skin lesions in pure neuritic leprosy. Electrodiagnostic findings early in the disease reveal demyelinating features, such as slowing of conduction velocity and prolongation of latencies, but as the disease progresses secondary axonal damage commonly ensues. Electrodiagnostic studies are also useful to monitor for toxicity secondary to therapy, particularly thalidomide-associated neuropathy. Nerve biopsy of a sensory cutaneous nerve is sometimes essential to confirm a diagnosis of leprosy. Significant advances in understanding of the pathogenesis, mapping of the genome, and other advances in molecular biology may result in better preventive and therapeutic modalities, and the goal of eradicating leprosy as a global problem may yet be realized. SN - 0148-639X UR - https://www.unboundmedicine.com/medline/citation/15372437/Leprosy_and_the_peripheral_nervous_system:_basic_and_clinical_aspects_ L2 - https://doi.org/10.1002/mus.20113 DB - PRIME DP - Unbound Medicine ER -