Keywords
classic neuritis
affected nerve trunks
inability degree
How to Cite
Abstract
Mycobacterium leprae (hansen’s baccillus) displays special immunogenic properties responsible by the
high incapacitating power of leprae. The aims of this study were to determine the clinical-epidemic profile
of multibacillar leprosum patients according to madri’s classification, correlate the baciloscopic index with the amount of nerve trunks affected by the classic neuritisprior and post-treatment, and correlate the inability degree of this patient with the clinical form at entrance and outcome. Medical records from 158 selected subjects with multibacilar leprosy from the center of reference in sanitary dermatology dr. Marcelo cândia, in marituba, pará, brazil were accessed to evaluate the baciloscopic and neurological exam. . Fifth two percent of the patients were in the range of 15 to 54 years, 80.4% Were male, 80% reach outcome for cure, and 84% were new cases. The predominant clinical form was dimorfa, comprising 68% of the cases. The virchowian form (mhv) was present in the majority of subjects with degree ii of incapacity, the presence of degree zero of incapacity was statistically significant in the dimorfa form (mhd), whose subjects displayed around 2.69 Fold more chance of evolving with neuritis symptoms than mhv. The most affected peripheric nerves at the moment and during the diagnosis were: tibia posterior, ulnar, fibula, and the to median nerve. In conclusion, mhv is at greater potential to develop degree ii of incapacity, whereas mhd barriers more frequently evolve to neuritis, and there is no difference among the nervous trunks affected in regard to the bacterious index.
References
2 Souza cs . Hanseníase: formas clínicas e diagnóstico diferencial. Medicina ribeirão preto 1997 jul; (30):325-34.
3 Croft rp , richardus jh , nicholls pg , smith wc . Nerve function impairment in leprosy: design, methodology, and intake status of a prospective cohort study of 2664 new leprosy cases in bangladesh (the bangladesh acute nerve damage study). Leprosy review 1999; 70 (2):140-59.
4 Solomon s, kurian n, ramadas p, rao ps . Incidence of nerve damage in leprosy patients treated with mdt. International journal of leprosy 1998; 66(4):451-6.
5 Araújo mg . Hanseníase no brasil. Revista da sociedade brasileira de medicina tropical 2003 maio – jun; 36(3):373-82.
6 Fleury rn . Dificuldades no emprego da classificação de ridley e jopling: uma análise morfológica. Hansen int. 1989; (14):101-6.
7 Pearson jmh , ross wf. Nerve involvement in leprosy - pathology, differential diagnosis and principles of management. Leprosy review 1975; (46):199-212.
8 Job ck . Nerve damage in leprosy. International journal of leprosy 1989; 57(2): 532-39.
9 Van brakel wh , khawas ib . Nerve damage in leprosy: an epidemiological and clinical study of 396 patients in west nepal-part 1. Definitions, methods and frequencies. Lepr rev. 1994; (65):204-21.
10 Pearson jmh . The evaluation of nerve damage in leprosy. Leprosy review 1982; (53):119-30.
11 Duncan me , pearson j. Neuritis in pregnancy and lactation. International journal of leprosy 1982; 50(1):31-8.
12 Garbino ja , nery ja , virmond m, Stump prn , baccarelli r, marques jr . Hanseníase: diagnóstico e tratamento da neuropatia. Sociedade brasileira de hansenologia, julho. 2003.
13 Talhari SN. Dermatologia tropical: hanseníase. Manaus: gráfica tropical; 1997.
14 Ridley ds , jopling wh . Classification of leprosy according to immunity (a five-group sistem) 1966; (34):255-73.
15 Brasil. Ministério da saúde. Guia de controle da hanseníase. 2 Ed. Brasília: Ministério da Saúde; 1994. 156p.
16 Aquino dmc , santos js , costa jml . Avaliação do programa de controle da hanseníase em um município hiperendêmico do estado do maranhão, brasil, 1991-1995. Cad. Saúde pública 2003 jan-fev; 19(1):119-25.
17 Lastória jc , macharelli ca , putinatti msma . Hanseníase: realidade no seu diagnóstico clínico. Hansen int. 2003; (28):53-8.
18 Silva ar , costa jml , silva mcp , rodrigues kca , barbosa j, santos js . Et al. Projeto buriticupu: relatório de 1993. Santa luzia: ufma (documento mimeografado); 1997.
20 Opromolla dva , lima ls , marques mb . Thalidomide in acute symptoms in leprosy. Hospital 1996; 69(4).
21 Lombardi c, suárez reg . Epidemiologia da hanseníase. In: talhari e, neves rg. Hanseníase. 3 Ed. Manaus: instituto superior de estudos da amazônia; 1997. p. 125-33.
22 Helene lmf , leão vm , minakawa mm . Perfis epidemiológicos e a avaliação de incapacidades físicas de hansenianos de uma ubs de são paulo. Hansen int. 2001; (26):5-13.
23 Barro mpaa . Avaliação da situação da hanseníase no município de londrina de 1997 à 2001: aspectos epidemiológicos, operacionais e organizacionais. Hansen int. 2004; (29): 10-17.
24 Opromolla dva . Noções de hansenologia. Bauru: Instituto Lauro de Sousa Lima; 2000.
25 Ignotti e, andrade vlg , sobroza pc , araújo ajg . Estudo de adesão ao tratamento da hanseníase no município de duque de caxias – rio de janeiro. Hansen int. 2001; (26): 23-30.
26 Reddy bn , bansal rd . An epidemiological study of leprosy disability in a lewprosy endemic rural population of pondicherry (south india). Indian j lepr 1984; 56(2): 191-9.
27 Sow so , tiendrebeogo a, hamed oould b, lienhart ce, ponnighaus jm . Disabilities observed in new cases of leprosy diagnosed in the bamako district (mali) in 1994. Acta leprol 1999; 11 (4):161-70.
28 Lana fcf , meléndez jgv , branco ac , teixeira s, malaquias lcc , oliveira vac , et al. Transmissão e controle da hanseníase no município de governador valadares / mg - período 1990 a 2000. Hansen int. 2002; 27 (2):83-92.
29 Richardus jh . Nerve function impairment in leprous at diagnosis and at completion of mdt: a retrospective cohort study of 786 patients in bangladesh. Leprosy review 1996; 67 (4):297-305.
30 Pimentel mif , nery jac , borges E, gonçalves rr , sarno em. O exame neurológico inicial na hanseníase multibacilar: correlação entre a presença de nervos afetados com incapacidades presentes no diagnóstico e com a ocorrência de neurites francas. An Bras Dermatol set – out; 78(5):561-8.
31 Shama p, jar hk , beena kr , kaur he , narayan r. Disabilities in multibacillary leprosy patients: before, during and after multidrug therapy. Indian J Lepr 1996; 68 (2):127-36.
32 Saunderson p. The epidemiology of reactions and nerve damage. Lepr rev 2000; 71 suppl: s106-s10.
33 Pimentel mif , Nery jac , Borges E, Gonçalves rr , Sarno em . Neurite silenciosa na hanseníase multibacilar avaliada através da evolução das incapacidades antes, durante e após a poliquimioterapia. An Bras Dermatol 2004 mar – abr; 79(2):169-79.
34 Moreira D. A importância da avaliação de incapacidades em membros superiores de pacientes portadores de hanseníase atendidos em nível ambulatorial. Revista fisioterapia em movimento 2001 abr - set; 21-4.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Downloads
