Clinical prediction rules for the diagnosis of neuritis in leprosy
Abstract Background Diagnosing neuritis in leprosy patients with neuropathic pain or chronic neuropathy remains challenging since no specific laboratory or neurophysiological marker is available. Methods In a cross-sectional study developed at a leprosy outpatient clinic in Rio de Janeiro, RJ, Brazi...
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| Format: | Article |
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BMC
2021-08-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-021-06545-2 |
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| author | Louise Mara Giesel Yara Hahr Marques Hökerberg Izabela Jardim Rodrigues Pitta Lígia Rocha Andrade Debora Bartzen Moraes José Augusto da Costa Nery Euzenir Nunes Sarno Marcia Rodrigues Jardim |
| author_facet | Louise Mara Giesel Yara Hahr Marques Hökerberg Izabela Jardim Rodrigues Pitta Lígia Rocha Andrade Debora Bartzen Moraes José Augusto da Costa Nery Euzenir Nunes Sarno Marcia Rodrigues Jardim |
| author_sort | Louise Mara Giesel |
| collection | DOAJ |
| description | Abstract Background Diagnosing neuritis in leprosy patients with neuropathic pain or chronic neuropathy remains challenging since no specific laboratory or neurophysiological marker is available. Methods In a cross-sectional study developed at a leprosy outpatient clinic in Rio de Janeiro, RJ, Brazil, 54 individuals complaining of neural pain (single or multiple sites) were classified into two groups (“neuropathic pain” or “neuritis”) by a neurological specialist in leprosy based on anamnesis together with clinical and electrophysiological examinations. A neurologist, blind to the pain diagnoses, interviewed and examined the participants using a standardized form that included clinical predictors, pain features, and neurological symptoms. The association between the clinical predictors and pain classifications was evaluated via the Pearson Chi-Square or Fisher’s exact test (p < 0.05). Results Six clinical algorithms were generated to evaluate sensitivity and specificity, with 95% confidence intervals, for clinical predictors statistically associated with neuritis. The most conclusive clinical algorithm was: pain onset at any time during the previous 90 days, or in association with the initiation of neurological symptoms during the prior 30-day period, necessarily associated with the worsening of pain upon movement and nerve palpation, with 94% of specificity and 35% of sensitivity. Conclusion This algorithm could help physicians confirm neuritis in leprosy patients with neural pain, particularly in primary health care units with no access to neurologists or electrophysiological tests. |
| first_indexed | 2024-12-22T07:25:54Z |
| format | Article |
| id | doaj.art-78c4bd174ac34f89b1e4e036db8243d9 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-12-22T07:25:54Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-78c4bd174ac34f89b1e4e036db8243d92022-12-21T18:34:08ZengBMCBMC Infectious Diseases1471-23342021-08-012111910.1186/s12879-021-06545-2Clinical prediction rules for the diagnosis of neuritis in leprosyLouise Mara Giesel0Yara Hahr Marques Hökerberg1Izabela Jardim Rodrigues Pitta2Lígia Rocha Andrade3Debora Bartzen Moraes4José Augusto da Costa Nery5Euzenir Nunes Sarno6Marcia Rodrigues Jardim7Leprosy Laboratory, Oswaldo Cruz InstituteLaboratory of Clinical Epidemiology, Evandro Chagas National Institute of Infectious DiseasesLeprosy Laboratory, Oswaldo Cruz InstituteLeprosy Laboratory, Oswaldo Cruz InstituteLeprosy Laboratory, Oswaldo Cruz InstituteLeprosy Laboratory, Oswaldo Cruz InstituteLeprosy Laboratory, Oswaldo Cruz InstituteLeprosy Laboratory, Oswaldo Cruz InstituteAbstract Background Diagnosing neuritis in leprosy patients with neuropathic pain or chronic neuropathy remains challenging since no specific laboratory or neurophysiological marker is available. Methods In a cross-sectional study developed at a leprosy outpatient clinic in Rio de Janeiro, RJ, Brazil, 54 individuals complaining of neural pain (single or multiple sites) were classified into two groups (“neuropathic pain” or “neuritis”) by a neurological specialist in leprosy based on anamnesis together with clinical and electrophysiological examinations. A neurologist, blind to the pain diagnoses, interviewed and examined the participants using a standardized form that included clinical predictors, pain features, and neurological symptoms. The association between the clinical predictors and pain classifications was evaluated via the Pearson Chi-Square or Fisher’s exact test (p < 0.05). Results Six clinical algorithms were generated to evaluate sensitivity and specificity, with 95% confidence intervals, for clinical predictors statistically associated with neuritis. The most conclusive clinical algorithm was: pain onset at any time during the previous 90 days, or in association with the initiation of neurological symptoms during the prior 30-day period, necessarily associated with the worsening of pain upon movement and nerve palpation, with 94% of specificity and 35% of sensitivity. Conclusion This algorithm could help physicians confirm neuritis in leprosy patients with neural pain, particularly in primary health care units with no access to neurologists or electrophysiological tests.https://doi.org/10.1186/s12879-021-06545-2NeuritisNeuropathic painLeprosyClinical prediction rulesSensitivitySpecificity |
| spellingShingle | Louise Mara Giesel Yara Hahr Marques Hökerberg Izabela Jardim Rodrigues Pitta Lígia Rocha Andrade Debora Bartzen Moraes José Augusto da Costa Nery Euzenir Nunes Sarno Marcia Rodrigues Jardim Clinical prediction rules for the diagnosis of neuritis in leprosy BMC Infectious Diseases Neuritis Neuropathic pain Leprosy Clinical prediction rules Sensitivity Specificity |
| title | Clinical prediction rules for the diagnosis of neuritis in leprosy |
| title_full | Clinical prediction rules for the diagnosis of neuritis in leprosy |
| title_fullStr | Clinical prediction rules for the diagnosis of neuritis in leprosy |
| title_full_unstemmed | Clinical prediction rules for the diagnosis of neuritis in leprosy |
| title_short | Clinical prediction rules for the diagnosis of neuritis in leprosy |
| title_sort | clinical prediction rules for the diagnosis of neuritis in leprosy |
| topic | Neuritis Neuropathic pain Leprosy Clinical prediction rules Sensitivity Specificity |
| url | https://doi.org/10.1186/s12879-021-06545-2 |
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