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Biomedicines
Volume 11
Issue 9
10.3390/biomedicines11092468
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Case Report

Leprosy Neuropathy in a Non-Endemic Area: A Clinical and Pathological Study

by
Stefano Cotti Piccinelli
1,2,
Matteo Tagliapietra
3,
Tiziana Cavallaro
3,
Beatrice Labella
1,4,
Barbara Risi
1,2,
Filomena Caria
2,
Simona Damioli
2,
Loris Poli
4,
Alessandro Padovani
1,4,
Sergio Ferrari
3 and
Massimiliano Filosto
1,2,*
1
Department of Clinical and Experimental Sciences, University of Brescia, 25100 Brescia, Italy
2
NeMO-Brescia Clinical Center for Neuromuscular Diseases, Guusago, 25064 Brescia, Italy
3
Neurology Unit, Department of Neurosciences, Biomedicine and Movement Sciences, 37100 Verona, Italy
4
Unit of Neurology, ASST Spedali Civili, 25100 Brescia, Italy
*
Author to whom correspondence should be addressed.
Biomedicines 2023, 11(9), 2468; https://doi.org/10.3390/biomedicines11092468
Submission received: 8 August 2023 / Revised: 13 August 2023 / Accepted: 17 August 2023 / Published: 6 September 2023
(This article belongs to the Section Molecular and Translational Medicine)
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Abstract

The extent of nerve involvement in leprosy is highly variable in distribution and clinical presentation. Mononeuropathies, multiple mononeuropathies, and polyneuropathies can present both in the context of a cutaneous and/or systemic picture and in the form of pure neuritic leprosy (PNL). The differential diagnosis of leprosy neuropathy remains challenging because it is a very rare condition and, especially in Western countries, is often overlooked. We report one case of the polyneuropathic form of PNL (P-PNL) and one case of multiple mononeuropathy in paucibacillary leprosy. In both cases, the diagnosis was achieved by performing a sural nerve biopsy, which showed subverted structure, severe infiltration of inflammatory cells in nerve fascicles, granulomatous abnormalities, and the presence of alcohol-acid-resistant, Ziehl–Neelsen-positive bacilli inside the nerve bundles. Leprosy remains an endemic disease in many areas of the world, and globalization has led to the spread of cases in previously disease-free countries. In this perspective, our report emphasizes that the diagnostic possibility of leprosy neuropathy should always be taken into account, even in Western countries, in the differential diagnostic process of an acquired sensory polyneuropathy or multineuropathy and confirms that nerve biopsy remains a useful procedure in working up neuropathies with unknown etiology.
Keywords: sensory polyneuropathy; leprosy; pure leprosy neuropathy; multiple mononeuropathy sensory polyneuropathy; leprosy; pure leprosy neuropathy; multiple mononeuropathy

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MDPI and ACS Style

Cotti Piccinelli, S.; Tagliapietra, M.; Cavallaro, T.; Labella, B.; Risi, B.; Caria, F.; Damioli, S.; Poli, L.; Padovani, A.; Ferrari, S.; et al. Leprosy Neuropathy in a Non-Endemic Area: A Clinical and Pathological Study. Biomedicines 2023, 11, 2468. https://doi.org/10.3390/biomedicines11092468

AMA Style

Cotti Piccinelli S, Tagliapietra M, Cavallaro T, Labella B, Risi B, Caria F, Damioli S, Poli L, Padovani A, Ferrari S, et al. Leprosy Neuropathy in a Non-Endemic Area: A Clinical and Pathological Study. Biomedicines. 2023; 11(9):2468. https://doi.org/10.3390/biomedicines11092468

Chicago/Turabian Style

Cotti Piccinelli, Stefano, Matteo Tagliapietra, Tiziana Cavallaro, Beatrice Labella, Barbara Risi, Filomena Caria, Simona Damioli, Loris Poli, Alessandro Padovani, Sergio Ferrari, and et al. 2023. "Leprosy Neuropathy in a Non-Endemic Area: A Clinical and Pathological Study" Biomedicines 11, no. 9: 2468. https://doi.org/10.3390/biomedicines11092468

APA Style

Cotti Piccinelli, S., Tagliapietra, M., Cavallaro, T., Labella, B., Risi, B., Caria, F., Damioli, S., Poli, L., Padovani, A., Ferrari, S., & Filosto, M. (2023). Leprosy Neuropathy in a Non-Endemic Area: A Clinical and Pathological Study. Biomedicines, 11(9), 2468. https://doi.org/10.3390/biomedicines11092468

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