medigraphic.com
ISSN 1727-897X (Electronic)

2016, Number 4

<< Back Next >>

Medisur 2016; 14 (4)

Hypertrophic neuropathy secondary to Hansen's disease. A case report

Rodríguez RMO, Herrera AD, Sánchez LA

Language: Spanish
References: 26
Page: 475-481
PDF size: 301.63 Kb.


ABSTRACT

We present the case 49-year-old unmarried woman treated at the hospital of Cienfuegos. The patient complained of weakness in the lower limbs and "numbness" (paresthesia) of all four extremities, which improved slightly after treatment. A year later, the muscle weakness and paresthesia worsened, particularly in the upper limbs. She also developed hypopigmented skin lesions on the chest and abdomen. The investigation was initiated due to suspicion of hypertrophic polyneuropathy. A biopsy of the hypochromic lesions was performed, which led to the conclusion that the patient suffered from a hypertrophic polyneuropathy secondary to tuberculoid Hansen's disease. We decided to present this case since a neuropathy is usually slow, insidious and has a long course in these patients; however, leprosy reactions can lead to acute nerve damage, resulting in disabilities and deformities. Consequently, it is important to act quickly in order to avoid them.


REFERENCES

  1. Espinoza Aguirre A, Jaramillo Antillón O, Arias Herrera A, Koon Rodríguez S, Aguilar Aguilar N, Chan A, et al. Normas para la atención integral y control de la enfermedad de Hansen en Costa Rica. San José, Costa Rica: OPS; 2013.

  2. World Health Organization. Leprosy: global situation [Internet]. Ginebra: WHO; 2012. [ cited 6 Jun 2015 ] Available from: http://www.who.int/lep/situation/en/.

  3. Organización Mundial de la Salud. Lepra. Nota descriptiva No. 101/ Enero 2014. Ginebra: OMS; 2014.

  4. MaitaGarcia X, Mejia Loma L, Maranon Mendoza LC, LuizagaPanozo S,Santander López A. Comportamiento clínico-epidemiológico de la lepra en el departamento de Cochabamba durante la década 2000-2010. RevCientCiencMéd [revista en Internet]. 2012 [ cited 13 May 2013 ] ; 15 (1): [aprox. 11p]. Available from: http://www.scielo.org.bo/scielo.php?pid=S1817-7 4332012000100003&script=sci_arttext.

  5. Suneetha S, Sigamoni A, Kurian N. Chacko CJ. The development of cutaneous lesions during follow-up of patients with primary neuritic leprosy. Int J Dermatol. 2005 ; 44 (3): 224-9.

  6. Hidalgo Pereira FI, Martínez López G, Fernández Juviel AI, Monte-Negro Calderón T. Caracterización epidemiológica de la lepra en el municipio de Cumanayagua (1983-2012). RevCubana HigEpidemiol [revista en Internet]. 2014 [ cited 23 Feb 2015 ] ; 52 (2): [aprox. 10p]. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext& pid=S1561-30032014000200003.

  7. Santos M, De Carvalho J, Brotto M, Bonfa E, Rocha F. Peripheral neuropathy in patients with primary antiphospholipid (Huges) syndrome. Lupus. 2010 ; 19 (5): 583-90.

  8. Morales C, Santos R, García V, Flores J, Martínez O. Neuropatía periférica en pacientes con artritis reumatoide. ArchNeurocienMex. 2009 ; 14 (1): 22-6.

  9. Ramos JM, Reyes F, Lemma D, Belinchón I, Gómez JR. Disability profile in leprosy patients’ diagnoses in a rural reference leprosy centre in Ethiopia during 1999-2009. Trop Doct. 2011 ; 41 (1): 51-3.

  10. Fitzpatrick T. Dermatología en Medicina General. 8va. ed. Buenos Aires: Editorial Médica Panamericana; 2014.

  11. Birdi TJ, Antia NH. Mechanisms involved in peripheral nerve damage in leprosy with special reference to insights mouse model. Int J LeprOther Mycobact Dis. 2003 ; 71 (4): 345-54.

  12. Garg R, Dehran M. Leprosy: a precipitating factor for complex regional pain syndrome. Minerva Anestesiol. 2010 ; 76 (9): 758-60.

  13. Contreras M, López N, Herrera E, Castillo R, Ruiz del Portal G, Busch RJ. Lepra importada y su dificultad en el medio actual: a propósito de 7 casos. ActasDermosifiliogr. 2011 ; 102 (2): 106-13.

  14. Shetty VP, Mehta LN, Irani PF, Antia NH. Study of the evolution of nerve damage in leprosy: Part II. Observation on the index branch of the radial cutaneous nerve in contacts of leprosy. Lepr Ind. 1980 ; 52 (1): 19-25.

  15. Shetty VP, Jacobs JM, Antia NH. The pathology of early leprous neuropathy. J Neurol Sci. 1988 ; 88 (1-3): 115-31.

  16. Gulia A, Fried I, Massone C. New insights in the pathogenesis and genetics of leprosy. F1000 Med Rep. 2010 ; 27 (2):

  17. Alter A, Grant A, Abel L, Alcaïs A, Schurr E. Leprosy as a genetic disease. Mamm Genome. 2011 ; 22 (1-2): 19-31.

  18. Capadia GD, Shetty VP, Khambati FA, Ghate SD. Effect of Corticosteroid Usage Combined With Multidrug Therapy on Nerve Damage Assessed Using Nerve Conduction Studies: A Prospective Cohort Study of 365 Untreated Multibacillary Leprosy Patients. J ClinNeurophysiol. 2010 ; 27 (1): 38-47.

  19. Veiga A, Costa A, Taipa R, Guimarães A, Pires MM. Hansen Neuropathy: Still a Possible Diagnosis in the Investigation of a Peripheral Neuropathy. Acta Med Port. 2015 ; 28 (3): 329-332.

  20. Vieira J, Riveira J, Martins AN, Da Silva J, Salgado C. Methemoglobinemia and dapsone levels in patients with leprosy. Braz J Infect Dis. 2010 ; 14 (3): 319-21.

  21. Scollard DM. Endothelial cell and the pathogenesis of lepromatous neuritis: Insights from the armadillo model. Microbes Infect. 2000 ; 2 (15): 1835-43.

  22. Vera L, Escalante WG, Gomez M, Ocampo J, Busso P, Singh P. Case of Diffuse Lepromatous Leprosy Associated with Mycobacterium lepromatosis. J ClinMicrobiol. 2011 ; 49 (12): 4366-8.

  23. Kimura J. Tests for less accessible regions of the nervous system. In: Kimura J, editors. Electrodiagnosis in diseases of the nerve and muscle: principles and practice. Oxford: Oxford University Press; 1989. p. 305-426.

  24. Thibault MW, Robinson LR, Franklin G, Fulton-Kehoe D. Use of the AAEM guidelines in electrodiagnosis of ulnar neuropathy at the elbow. Am J PhysMedRehabil. 2005 ; 84 (4): 267-73.

  25. de Faria Grossi MA. Orientações para uso: Corticosteroides em Hanseníase. Série A. Normas e Manuais Técnicos. Brasília: Ministério da Saúde do Brasil; 2010.

  26. Abreu Guillén GJ, Escalona Veloz R. Caracterización clinicoepidemiológica de pacientes con estados reaccionales de lepra. MEDISAN [revista en Internet]. 2015 [ cited 23 Ene 2016 ] ; 9 (7): [aprox. 8p]. Available from: http://scielo.sld.cu/scielo.php?script=sci_arttext& pid=S1029-30192015000700005.




2020     |     www.medigraphic.com