Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil
IntroductionLeprosy 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 ca...
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Frontiers Media S.A.
2022-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.865485/full |
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| author | Izabela Jardim Rodrigues Pitta Izabela Jardim Rodrigues Pitta Izabela Jardim Rodrigues Pitta Mariana Andrea Hacker Robson Teixeira Vital Robson Teixeira Vital Ligia Rocha Andrade Ligia Rocha Andrade Clarissa Neves Spitz Clarissa Neves Spitz Anna Maria Sales Sergio Luiz Gomes Antunes Euzenir Nunes Sarno Marcia Rodrigues Jardim Marcia Rodrigues Jardim Marcia Rodrigues Jardim |
| author_facet | Izabela Jardim Rodrigues Pitta Izabela Jardim Rodrigues Pitta Izabela Jardim Rodrigues Pitta Mariana Andrea Hacker Robson Teixeira Vital Robson Teixeira Vital Ligia Rocha Andrade Ligia Rocha Andrade Clarissa Neves Spitz Clarissa Neves Spitz Anna Maria Sales Sergio Luiz Gomes Antunes Euzenir Nunes Sarno Marcia Rodrigues Jardim Marcia Rodrigues Jardim Marcia Rodrigues Jardim |
| author_sort | Izabela Jardim Rodrigues Pitta |
| collection | DOAJ |
| description | IntroductionLeprosy 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.MethodsWe 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.ResultsOf 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.DiscussionOur 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. |
| first_indexed | 2024-12-13T09:05:09Z |
| format | Article |
| id | doaj.art-0092cc0b81be4c6fa6b4013c8412820f |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-13T09:05:09Z |
| publishDate | 2022-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-0092cc0b81be4c6fa6b4013c8412820f2022-12-21T23:53:05ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-03-01910.3389/fmed.2022.865485865485Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – BrazilIzabela Jardim Rodrigues Pitta0Izabela Jardim Rodrigues Pitta1Izabela Jardim Rodrigues Pitta2Mariana Andrea Hacker3Robson Teixeira Vital4Robson Teixeira Vital5Ligia Rocha Andrade6Ligia Rocha Andrade7Clarissa Neves Spitz8Clarissa Neves Spitz9Anna Maria Sales10Sergio Luiz Gomes Antunes11Euzenir Nunes Sarno12Marcia Rodrigues Jardim13Marcia Rodrigues Jardim14Marcia Rodrigues Jardim15Leprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilPost-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, BrazilDepartment of Neurology, Antonio Pedro University Hospital/ Fluminense Federal University, Niteroi, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilDepartment of Neurology, Pedro Ernesto University Hospital/ Rio de Janeiro State University, Rio de Janeiro, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilPost-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilPost-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilLeprosy Laboratory, Oswaldo Cruz Institute, Fiocruz, Rio de Janeiro, BrazilPost-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro, Rio de Janeiro, BrazilDepartment of Neurology, Pedro Ernesto University Hospital/ Rio de Janeiro State University, Rio de Janeiro, BrazilIntroductionLeprosy 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.MethodsWe 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.ResultsOf 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.DiscussionOur 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.https://www.frontiersin.org/articles/10.3389/fmed.2022.865485/fullleprosypure neural leprosyleprosy reactionsneuritisneuropathic pain |
| spellingShingle | Izabela Jardim Rodrigues Pitta Izabela Jardim Rodrigues Pitta Izabela Jardim Rodrigues Pitta Mariana Andrea Hacker Robson Teixeira Vital Robson Teixeira Vital Ligia Rocha Andrade Ligia Rocha Andrade Clarissa Neves Spitz Clarissa Neves Spitz Anna Maria Sales Sergio Luiz Gomes Antunes Euzenir Nunes Sarno Marcia Rodrigues Jardim Marcia Rodrigues Jardim Marcia Rodrigues Jardim Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil Frontiers in Medicine leprosy pure neural leprosy leprosy reactions neuritis neuropathic pain |
| title | Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil |
| title_full | Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil |
| title_fullStr | Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil |
| title_full_unstemmed | Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil |
| title_short | Leprosy Reactions and Neuropathic Pain in Pure Neural Leprosy in a Reference Center in Rio de Janeiro – Brazil |
| title_sort | leprosy reactions and neuropathic pain in pure neural leprosy in a reference center in rio de janeiro brazil |
| topic | leprosy pure neural leprosy leprosy reactions neuritis neuropathic pain |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.865485/full |
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