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Pure neural leprosy: Diagnostic value of the polymerase chain reaction
Author(s) -
Bezerra Da Cunha Francisco M.,
Werneck Mauricio C. M.,
Scola Rosana H.,
Werneck Lineu C.
Publication year - 2006
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.20465
Subject(s) - leprosy , mycobacterium leprae , polymerase chain reaction , biopsy , nerve biopsy , medicine , tuberculoid leprosy , pathology , biology , lepromatous leprosy , peripheral neuropathy , gene , biochemistry , endocrinology , diabetes mellitus
Pure neural leprosy (PNL) is often difficult to diagnose when acid‐fast bacilli (AFB) cannot be detected. We undertook the present study to evaluate use of the polymerase chain reaction (PCR) in diagnosing PNL. Fifty‐eight patients (41 men and 17 women) suspected of pure neural leprosy (PNL) were examined. Patients were classified as borderline tuberculoid (BT, 40 cases) and polar tuberculoid (TT, 18 cases) types. Nerve biopsy was performed and was positive for AFB in 20 patients (all BT patients), i.e., 34.5% of total cases. DNA was extracted from the nerve biopsy samples and amplified using PCR for a specific repeated sequence of DNA from Mycobacterium leprae . PCR analysis was positive in the nerve samples from 29 patients (50%), 27 of the BT type, and 2 of the TT type patients. Further, PCR analysis was positive in 14 of 38 cases that were negative for AFB by nerve biopsy, of which 12 were of the BT type and 2 the TT type. PCR analysis proved to be a useful method to investigate pure neural leprosy, enabling confirmation of the diagnosis in more than a third of the cases that were negative for AFB by nerve biopsy. Muscle Nerve 2006