Contribuição ao estudo histopatológico do epineuro cubital em doentes de hanseníase indiferenciada
DOI:
https://doi.org/10.47878/hi.1983.v8.35584Keywords:
Hanseniasis, Epineurium, PathologyAbstract
Twelve hanseniasis patients, undifferentiated group, with negative bacilloscopy and having undergone no prior treatment, were submitted to a biopsy of the cubital epineurium for histopathological study. All subjects were clinically observed after one month, and six of them were examined 4 to 5 years afterwards. Histopathology of the epineurium presented acid-fast bacilli in one patient and tuberculoid granuloma formation tendency in another. Epineural thickening was observed in nine patients and perivascular lymphomonocuclear inflammatory infiltration in six. The clinical examination after 1 month in the 12 patients as well as after 4 to 5 years in 6 of them, demonstrated innocuousness of the performed biopsy. Four to five years after the initial observation, the clinical examination showed that two patients who remained Mitsuda negative did not resent histopathologically thickened epineurium at the beginning, while in four patients who then presented positive Mitsuda, the initial histopathological examination showed epineural thickening. Among the nine patients having a histopathologically thickened epineurium, six did not present initial lesions in the upper limbs. Therefore, the study of the cubital epineurium early thickening deserves special mention, and should be performed in a larger number of patients, as well as in control groups, since the follow-up of four among six patients showed epineural thickening and reversal of the Mitsuda reactions to
positivity.
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References
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2 ALMEIDA NETO, E.; DIAS JORGE, M.; LOBO, O.P.; MIGDAL, S. Dingnóstico precoce da hanseníase de Virchow (lepra lepromatosa), pela exploração clínica e exame histopatológico de nervos superficiais cutâneos. Bol. Serv. Nac. Lepra, 29(1/2):29-33, 1970.
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7 BASOMBRIO, G. & BOSQ, F.J.P. Lepra lepromatosa de comienzo oligoneuritico puro. Leprologia, 4(3):31, 1959.
8 BRANCO RIBEIRO, E. Achado cirúrgico em um caso de lepra nervosa considerado extinto. Rev. Bras. Leprol., 6 (n. esp.):175-176, 1938.
9 BRESANI SILVA, F. El sindrome neural leproso: ensayo de sistematización. Lima, Rev. Peruan de Salud Pública, 1958. 470p.
10 BROTTO, W. Aspectos neurológicos da lepra. Rev. Bras. Leprol., 82(2): 135-144, 1954.
11 CALLAWAY, J.C.; FITE, G.L.; RIORDAN, D.C. Ulnar and median neuritis due to leprosy. Report of one hundred cases treated surgically. Int. J. Lepr., 32(3):285-291, 1964.
12 CHATTERJI, S.N. Thickened nerves in leprosy in relation to skin lesions. mat. J. Lepr., 1(3) :283-292, 1933.
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14 COHEN, S. Análise dos resultados de 5051 exames histopatológicos em suspeitos de hanseníase no período de 1975 a 1980 efetuados na Seção de Anatomia Patológica do Instituto de Saúde do Estado de São Paulo. São Paulo, 1981. 50p. (Tese — Faculdade
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17 DEHIO, K. On the lepra anaesthetica and the pathogenetical relation of its disease: appearances. Lepr. India, 24 (2) :78-83, 1952.
18 DISCAMPS, G. & CARAYON, A. Les lésions nerveuses dans la lèpre en fonction de la topographie et du calibre des nerfs: étude histopathologique. Med. Trop., 37(4):473-478, 1977.
19 FITE, G.L. The pathology and pathogenesis of leprosy. Ann. N. Y. Acad. Sci., 54 (1) :28-33, 1951.
20 GOMEZ ORBANEJA, J. & GARCIA PEREZ, A. Lepra. Madrid, Montalvo, 1953. 387p.
21 GRIECO, V. Aspectos histológicos das nevrites na lepra. Rev. Bras. Leprol., 4(3) :271-305, 1936.
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23 HARKIN, J.C. Localization of the cellular site of collagen synthesis in peripheral nerves by electron microscopic autoradiography using H3-Proline. In: INTERNATIONAL CONGRESS OF NEUROPATHOLOGY, 5., Zu-rich, 1965. Proceedings. Amsterdam, Excerpta Medica Foundation, 1966. p.861-863. (International Congress Series, 100)
24 HAYASHI, F. Mitsuda's skin reaction in leprosy. Int. J. Lepr., 1(1) :31-38, 1933.
25 IYER, C.G.S. Prediletion of M. leprae for nerves. Neuro-histopathologic observations. Mt. J. Lepr. 5,9(2/3) : 634-645, 1965.
26 JEANSELME, E. Etude anatomo-clinique. H. Caracteres histologiques et bactériologiques de la névrite hansénienne. In: La lèpre. Paris, Doin, 1934, p.373-381.
27 JOB, C.K. Mycobacterium leprae in nerve lesions in lepromatous leprosy: an electron microscopic study. Arch. Path., 89 (3) :195-207, 1970.
28 JOB, C.K. & DESIKAN, K.V. Pathologic changes and their distribution in peripheral nerves in lepromatous leprosy. Int. J. Lepr., 86(3) :257-270, 1968.
29 JULIAO, O.F. Contribuiçdo para o estudo do diagnóstico clínico da lepra nervosa. São Paulo, 1945. 203p. (Tese — Faculdade de Medicina da Universidade de São Paulo).
30 JULIAO, O.F. As manifestações neurológicas da lepra. Rev. Med., 47(2) : 63-71, 1963.
31 JUNQUEIRA, L.C.U.; MONTES, G.S.; ALMEIDA NETO, E.; BARROS, C.; TEDESCO-MARCHESE, A.J. The collagen of permanently damaged nerves in human leprosy. Int. J. Lepr., 48(3) :291-297, 1980.
32 KEAN, B.H. & CHILDRESS, M.E. A summary of 103 autopsies on leprosy patients on the isthmus of Panama. Int. J. Lepr., 10(1) :51-58, 1942.
33 KHANOLKAR, V.R. Studies in the histology of early lesions in leprosy. New Delhi, Indian Council of Medical Research, 1951. 18p. (Special Report Series, 19).
34 KLINGMt)LLER, V. Periphere Nerven. In: JADASSOHN, J. Handbuch der Haut and Geschlechtskrankheiten. Berlin, 1930. v.10, pt.2, p.452-455.
35 LANGUILLON, J. & CARAYON, A. La névrite lépreuse. In: Précis de léprologie: clinique et thérapeutique de la lepre en Afrique Noire. Paris, Masson, 1969. p.93-101.
36 MANZI, R.O.; ROZENWURCEL, H.J.; MAU, L.L.; BAUDINO, R.A.; MARZETTI, A.A. Patologia y clinica de Ias alteraeiones del nervio cubital en la enfermedad de Hansen. Leprologia, 18(2):116-122, 1973.
37 MARIANO, J. Considerações sobre os aspectos clínicos e localização da nevrite leprosa. Arq. Mineir. Leprol., 13(2) :136-139, 1953.
38 MITSUDA, K. & OGAWA, M. A study of one hundred and fifty autopsies on cases of leprosy. Int. J. Lepr., 5(1):53-60, 1937.
39 MONRAD-KROHN, G.H. The neurological aspect of leprosy ("Spedalskhed"). Christiania, Jacob Dybwad, 1923. 78p.
40 MUIR, E. Aspectos clínicos e histológicos das lesões dos nervos. In: Lepra: diagnóstico, tratamento e profilaxia; trad. Hamilton Palermo. Rio de Janeiro, Serviço Nacional de Lepra, 1947, cap. 7, p.32-37.
41 PARDO CASTELL6, V. & PIREYRO, R. Los cambios anatomo-patológicos de los nervios en la lepra lepromatosa. In: CONGRESO INTERNACIONAL DE LA LEPRA, 5., Habana, 1948. Memoria, Cuba, Cenit, 1949 p.541-544.
42 PEARSON, J.M.H. & WEDDELL, A.G. M. Perineural changes in untreated leprosy. Lepr. Rev., 46(1) :51-67, 1975.
43 SABRAZES, M. Diagnostic de la lepre nerveuse pure au début de son evolution par l'examen bactérioscopique d'un filet nerveux sensitif excise' au niveau d'une zone analgésique: rôle des moustiques dans )'inoculation de la lepre. J. Physiol. Pathol. Gen., 2: 985-992, 1900.
44 SILVEIRA, L.M. Neurites lepróticas. In: CONFERÊNCIA PANAMERICANA DE LEPRA, 2., Rio de Janeiro, 1946. v.2, p.203-210.
45 SOUZA CAMPOS, N. & BECHELL1, L.M. Sintomatologia nervosa da lepra. Rio de Janeiro, Serviço Nacional de Lepra, 1946. 193p.
46 SUNDERLAND, S. The connective tissues of peripheral nerves. Brain, 88: 841-854, 1965.
47 SUNDERLAND, S. The internal anatomy of nerve trunks in relation to theneural lesions of leprosy. Brain, 96 (4) :865-888, 1973.
48 TEDESCO-MARCHESE, A.J. Contribuição ao estudo do tratamento cirúrgico das neurites hansenianas. São Paulo, 1980. 71p. (Tese — Faculdade de Medicina da Universidade de São Paulo).
49 THOMAS, P.K. & OLSSON, Y. Microscopic anatomy and function of the connective tissue components of the peripheral nerve. In: DYCK, P.J.; THOMAS, P.K.; LAMBERT, E.H., eds. Peripheral neuropathy. Philadelphia, Saunders, 1975. v.1, cap. 9, p.168-189.
50 TOLOSA, A. Nevrites leprosas. Bol. Soc. Med. Cir. S. Paulo, 1:161-181, 1930.
51 TORSSUJEW, N.A. Morphologic changes of the cutaneous nerves in leprosy. Int. J. Lepr., 8(4):467-480, 1940.
52 WEDDELL, A.G.M.; PEARSON, J.M.H.; MORRIS, J.H. Mechanisms of nerve damage in tuberculoid and lepromatous leprosy. In: INTERNATIONAL LEPROSY CONGRESS, 10., Bergen, 1973. Transactions apud hit. J. Lepr., 41(4):630, 1973.
53 WEDDELL, G.; PALMER, E.; REES, R.J.W.; JAMISON, D.G. Experimental observations related to the histopathology of leprosy. In: WOLSTENHOLME, G.E.W. & O'CONNOR, M., eds. Pathogenesis of leprosy. London, Churchill, 1963. 3-30 (Ciba Foundation Study Group, 15).
54 WOIT, O. Das Rückenmark, die peripheren Nerven and die Hautflecken bei der Lepra maculoanaesthetica. Lepra. Bibliotheca Internationalis, 1(1/2) : 50-62, 1900.
2 ALMEIDA NETO, E.; DIAS JORGE, M.; LOBO, O.P.; MIGDAL, S. Dingnóstico precoce da hanseníase de Virchow (lepra lepromatosa), pela exploração clínica e exame histopatológico de nervos superficiais cutâneos. Bol. Serv. Nac. Lepra, 29(1/2):29-33, 1970.
3 ANTIA, N.H.; PANDYA, S.S.; DASTUR, D.K. Nerves in the arm in leprosy. I. Clinical electrodiagnostic and operative aspects. Int. J. Lepr., 38 (1) : 12-29, 1970.
4 ANTOLA, M.C.; ORTIZ, M.C.; VAQUERO, N.; JAURRIETA, C.; ALCON, R.D.; TORCHINSKY, O.M. Las neuropatias hansenianas. Temas Leprol., 21(63/64):1-123, 1978.
6 ARAICO SALAZAR, J. Síndrome neurológico en la lepra. México, 1963, 134p. (Tese — Facultad Nacional de Medicina de la Universidad Nacional Autónoma de Mexico)
6 AZULAY, R.D. Manifestações iniciais e formas clínicas da lepra: sua importância epidemiológica. In: CONFERÊNCIA PANAMERICANA DE LEPRA, 2., Rio de Janeiro, 1946. Actas., v.1, p.110-117.
7 BASOMBRIO, G. & BOSQ, F.J.P. Lepra lepromatosa de comienzo oligoneuritico puro. Leprologia, 4(3):31, 1959.
8 BRANCO RIBEIRO, E. Achado cirúrgico em um caso de lepra nervosa considerado extinto. Rev. Bras. Leprol., 6 (n. esp.):175-176, 1938.
9 BRESANI SILVA, F. El sindrome neural leproso: ensayo de sistematización. Lima, Rev. Peruan de Salud Pública, 1958. 470p.
10 BROTTO, W. Aspectos neurológicos da lepra. Rev. Bras. Leprol., 82(2): 135-144, 1954.
11 CALLAWAY, J.C.; FITE, G.L.; RIORDAN, D.C. Ulnar and median neuritis due to leprosy. Report of one hundred cases treated surgically. Int. J. Lepr., 32(3):285-291, 1964.
12 CHATTERJI, S.N. Thickened nerves in leprosy in relation to skin lesions. mat. J. Lepr., 1(3) :283-292, 1933.
13 CHATTERJI, S.N. Thickening of the ulnar nerve in leprosy and its treatment. Lepr. India, 23(1):74-82, 1951.
14 COHEN, S. Análise dos resultados de 5051 exames histopatológicos em suspeitos de hanseníase no período de 1975 a 1980 efetuados na Seção de Anatomia Patológica do Instituto de Saúde do Estado de São Paulo. São Paulo, 1981. 50p. (Tese — Faculdade
de Medicina da Universidade de São Paulo).
15 DASTUR, D.K. The role of the perineurium as revealed in leprous neuritis. In: ALL INDIA LEPROSY WORKERS CONFERENCE, 14. / CONFERENCE OF THE INDIAN ASSOCIATION OF LEPROLOGISTS, 10., Baroda, 1976 apud Lepr. India, 48(suppl. 4) :500-503, 1976.
16 DASTUR, D.K.; PANDYA, S.S.; AN- TIA, N.H. Nerves in the arm in leprosy. II. Pathology, pathogenesis and clinical correlations. Int. J. Lepr., 38(1):30-48, 1970.
17 DEHIO, K. On the lepra anaesthetica and the pathogenetical relation of its disease: appearances. Lepr. India, 24 (2) :78-83, 1952.
18 DISCAMPS, G. & CARAYON, A. Les lésions nerveuses dans la lèpre en fonction de la topographie et du calibre des nerfs: étude histopathologique. Med. Trop., 37(4):473-478, 1977.
19 FITE, G.L. The pathology and pathogenesis of leprosy. Ann. N. Y. Acad. Sci., 54 (1) :28-33, 1951.
20 GOMEZ ORBANEJA, J. & GARCIA PEREZ, A. Lepra. Madrid, Montalvo, 1953. 387p.
21 GRIECO, V. Aspectos histológicos das nevrites na lepra. Rev. Bras. Leprol., 4(3) :271-305, 1936.
22 HANSEN, G.A. & LOOFT, C. Leprosy: in its clinical and pathological aspects. Bristol, John Wright, 1895. 159p.
23 HARKIN, J.C. Localization of the cellular site of collagen synthesis in peripheral nerves by electron microscopic autoradiography using H3-Proline. In: INTERNATIONAL CONGRESS OF NEUROPATHOLOGY, 5., Zu-rich, 1965. Proceedings. Amsterdam, Excerpta Medica Foundation, 1966. p.861-863. (International Congress Series, 100)
24 HAYASHI, F. Mitsuda's skin reaction in leprosy. Int. J. Lepr., 1(1) :31-38, 1933.
25 IYER, C.G.S. Prediletion of M. leprae for nerves. Neuro-histopathologic observations. Mt. J. Lepr. 5,9(2/3) : 634-645, 1965.
26 JEANSELME, E. Etude anatomo-clinique. H. Caracteres histologiques et bactériologiques de la névrite hansénienne. In: La lèpre. Paris, Doin, 1934, p.373-381.
27 JOB, C.K. Mycobacterium leprae in nerve lesions in lepromatous leprosy: an electron microscopic study. Arch. Path., 89 (3) :195-207, 1970.
28 JOB, C.K. & DESIKAN, K.V. Pathologic changes and their distribution in peripheral nerves in lepromatous leprosy. Int. J. Lepr., 86(3) :257-270, 1968.
29 JULIAO, O.F. Contribuiçdo para o estudo do diagnóstico clínico da lepra nervosa. São Paulo, 1945. 203p. (Tese — Faculdade de Medicina da Universidade de São Paulo).
30 JULIAO, O.F. As manifestações neurológicas da lepra. Rev. Med., 47(2) : 63-71, 1963.
31 JUNQUEIRA, L.C.U.; MONTES, G.S.; ALMEIDA NETO, E.; BARROS, C.; TEDESCO-MARCHESE, A.J. The collagen of permanently damaged nerves in human leprosy. Int. J. Lepr., 48(3) :291-297, 1980.
32 KEAN, B.H. & CHILDRESS, M.E. A summary of 103 autopsies on leprosy patients on the isthmus of Panama. Int. J. Lepr., 10(1) :51-58, 1942.
33 KHANOLKAR, V.R. Studies in the histology of early lesions in leprosy. New Delhi, Indian Council of Medical Research, 1951. 18p. (Special Report Series, 19).
34 KLINGMt)LLER, V. Periphere Nerven. In: JADASSOHN, J. Handbuch der Haut and Geschlechtskrankheiten. Berlin, 1930. v.10, pt.2, p.452-455.
35 LANGUILLON, J. & CARAYON, A. La névrite lépreuse. In: Précis de léprologie: clinique et thérapeutique de la lepre en Afrique Noire. Paris, Masson, 1969. p.93-101.
36 MANZI, R.O.; ROZENWURCEL, H.J.; MAU, L.L.; BAUDINO, R.A.; MARZETTI, A.A. Patologia y clinica de Ias alteraeiones del nervio cubital en la enfermedad de Hansen. Leprologia, 18(2):116-122, 1973.
37 MARIANO, J. Considerações sobre os aspectos clínicos e localização da nevrite leprosa. Arq. Mineir. Leprol., 13(2) :136-139, 1953.
38 MITSUDA, K. & OGAWA, M. A study of one hundred and fifty autopsies on cases of leprosy. Int. J. Lepr., 5(1):53-60, 1937.
39 MONRAD-KROHN, G.H. The neurological aspect of leprosy ("Spedalskhed"). Christiania, Jacob Dybwad, 1923. 78p.
40 MUIR, E. Aspectos clínicos e histológicos das lesões dos nervos. In: Lepra: diagnóstico, tratamento e profilaxia; trad. Hamilton Palermo. Rio de Janeiro, Serviço Nacional de Lepra, 1947, cap. 7, p.32-37.
41 PARDO CASTELL6, V. & PIREYRO, R. Los cambios anatomo-patológicos de los nervios en la lepra lepromatosa. In: CONGRESO INTERNACIONAL DE LA LEPRA, 5., Habana, 1948. Memoria, Cuba, Cenit, 1949 p.541-544.
42 PEARSON, J.M.H. & WEDDELL, A.G. M. Perineural changes in untreated leprosy. Lepr. Rev., 46(1) :51-67, 1975.
43 SABRAZES, M. Diagnostic de la lepre nerveuse pure au début de son evolution par l'examen bactérioscopique d'un filet nerveux sensitif excise' au niveau d'une zone analgésique: rôle des moustiques dans )'inoculation de la lepre. J. Physiol. Pathol. Gen., 2: 985-992, 1900.
44 SILVEIRA, L.M. Neurites lepróticas. In: CONFERÊNCIA PANAMERICANA DE LEPRA, 2., Rio de Janeiro, 1946. v.2, p.203-210.
45 SOUZA CAMPOS, N. & BECHELL1, L.M. Sintomatologia nervosa da lepra. Rio de Janeiro, Serviço Nacional de Lepra, 1946. 193p.
46 SUNDERLAND, S. The connective tissues of peripheral nerves. Brain, 88: 841-854, 1965.
47 SUNDERLAND, S. The internal anatomy of nerve trunks in relation to theneural lesions of leprosy. Brain, 96 (4) :865-888, 1973.
48 TEDESCO-MARCHESE, A.J. Contribuição ao estudo do tratamento cirúrgico das neurites hansenianas. São Paulo, 1980. 71p. (Tese — Faculdade de Medicina da Universidade de São Paulo).
49 THOMAS, P.K. & OLSSON, Y. Microscopic anatomy and function of the connective tissue components of the peripheral nerve. In: DYCK, P.J.; THOMAS, P.K.; LAMBERT, E.H., eds. Peripheral neuropathy. Philadelphia, Saunders, 1975. v.1, cap. 9, p.168-189.
50 TOLOSA, A. Nevrites leprosas. Bol. Soc. Med. Cir. S. Paulo, 1:161-181, 1930.
51 TORSSUJEW, N.A. Morphologic changes of the cutaneous nerves in leprosy. Int. J. Lepr., 8(4):467-480, 1940.
52 WEDDELL, A.G.M.; PEARSON, J.M.H.; MORRIS, J.H. Mechanisms of nerve damage in tuberculoid and lepromatous leprosy. In: INTERNATIONAL LEPROSY CONGRESS, 10., Bergen, 1973. Transactions apud hit. J. Lepr., 41(4):630, 1973.
53 WEDDELL, G.; PALMER, E.; REES, R.J.W.; JAMISON, D.G. Experimental observations related to the histopathology of leprosy. In: WOLSTENHOLME, G.E.W. & O'CONNOR, M., eds. Pathogenesis of leprosy. London, Churchill, 1963. 3-30 (Ciba Foundation Study Group, 15).
54 WOIT, O. Das Rückenmark, die peripheren Nerven and die Hautflecken bei der Lepra maculoanaesthetica. Lepra. Bibliotheca Internationalis, 1(1/2) : 50-62, 1900.
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1983-06-30
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KATZ DR, ALMEIDA NETO E de, MARTINS JEC, TSANACLIS AMC. Contribuição ao estudo histopatológico do epineuro cubital em doentes de hanseníase indiferenciada . Hansen. Int. [Internet]. 1983 Jun. 30 [cited 2024 May 19];8(1):22-45. Available from: https://periodicos.saude.sp.gov.br/hansenologia/article/view/35584
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