Hansen's neuritis revisited - A clinicopathological study

Navya Jaiswal, Shrijeet Chakraborti, Kashinath Nayak, Shivananda Pai, B. P. Shelley, Saraswathy Sreeram, K. C. Rakshith, B. V. Suresh, Z. K. Misri, Hansraj Alva, N. Shankar

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Abstract

Introduction: Leprosy affecting the nerve solely or with concomitant skin lesions is not an uncommon condition in clinical practice. It is responsible for extensive morbidity and often poses a diagnostic challenge. This study aims to highlight the clinicopathological features of Hansen's neuritis (HN). Materials and Methods: In this retrospective study, cases of histologically diagnosed HN, from January 2010 to July 2017, were reviewed in the light of clinical features, treatment history, and outcome. Results: There were 18 cases of HN which accounted for 3.97% of total nerve biopsy samples (n = 453) and 0.02% of total histopathology samples (n = 81,013). The male: female ratio was 5:1 in the cases of HN. Age range was 20-79 years with a mean age of 42.4 years (standard deviation: ±14.03). Among the HN cases, there were 13 cases of pure neuritic leprosy (61.1%). Mononeuritis multiplex was the most common finding in the nerve conduction study. Six (33.3%) cases exhibited histological features of borderline tuberculoid leprosy, followed by five (27.8%) cases of mid-borderline features, three (16.7%) cases each of borderline lepromatous and burnt-out HN, and one (5.6%) case of polar tuberculoid leprosy. Lepra bacilli were detected on Fite-Faraco stain in 44.4% cases. Conclusion: Diagnosis of HN depends on astute search for skin lesions, nerve thickening or tenderness, sensory or motor symptoms, histopathological examination, and demonstration of lepra bacilli.

Original languageEnglish
Pages (from-to)42-55
Number of pages14
JournalJournal of Neurosciences in Rural Practice
Volume9
Issue number1
DOIs
Publication statusPublished - 01-01-2018

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Neuritis
Tuberculoid Leprosy
Leprosy
Bacillus
Borderline Leprosy
Paucibacillary Leprosy
Multibacillary Leprosy
Mononeuropathies
Skin
Neural Conduction
Coloring Agents
Retrospective Studies
History
Morbidity
Biopsy

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Clinical Neurology

Cite this

Jaiswal, Navya ; Chakraborti, Shrijeet ; Nayak, Kashinath ; Pai, Shivananda ; Shelley, B. P. ; Sreeram, Saraswathy ; Rakshith, K. C. ; Suresh, B. V. ; Misri, Z. K. ; Alva, Hansraj ; Shankar, N. / Hansen's neuritis revisited - A clinicopathological study. In: Journal of Neurosciences in Rural Practice. 2018 ; Vol. 9, No. 1. pp. 42-55.
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Hansen's neuritis revisited - A clinicopathological study. / Jaiswal, Navya; Chakraborti, Shrijeet; Nayak, Kashinath; Pai, Shivananda; Shelley, B. P.; Sreeram, Saraswathy; Rakshith, K. C.; Suresh, B. V.; Misri, Z. K.; Alva, Hansraj; Shankar, N.

In: Journal of Neurosciences in Rural Practice, Vol. 9, No. 1, 01.01.2018, p. 42-55.

Research output: Contribution to journalArticle

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T1 - Hansen's neuritis revisited - A clinicopathological study

AU - Jaiswal, Navya

AU - Chakraborti, Shrijeet

AU - Nayak, Kashinath

AU - Pai, Shivananda

AU - Shelley, B. P.

AU - Sreeram, Saraswathy

AU - Rakshith, K. C.

AU - Suresh, B. V.

AU - Misri, Z. K.

AU - Alva, Hansraj

AU - Shankar, N.

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N2 - Introduction: Leprosy affecting the nerve solely or with concomitant skin lesions is not an uncommon condition in clinical practice. It is responsible for extensive morbidity and often poses a diagnostic challenge. This study aims to highlight the clinicopathological features of Hansen's neuritis (HN). Materials and Methods: In this retrospective study, cases of histologically diagnosed HN, from January 2010 to July 2017, were reviewed in the light of clinical features, treatment history, and outcome. Results: There were 18 cases of HN which accounted for 3.97% of total nerve biopsy samples (n = 453) and 0.02% of total histopathology samples (n = 81,013). The male: female ratio was 5:1 in the cases of HN. Age range was 20-79 years with a mean age of 42.4 years (standard deviation: ±14.03). Among the HN cases, there were 13 cases of pure neuritic leprosy (61.1%). Mononeuritis multiplex was the most common finding in the nerve conduction study. Six (33.3%) cases exhibited histological features of borderline tuberculoid leprosy, followed by five (27.8%) cases of mid-borderline features, three (16.7%) cases each of borderline lepromatous and burnt-out HN, and one (5.6%) case of polar tuberculoid leprosy. Lepra bacilli were detected on Fite-Faraco stain in 44.4% cases. Conclusion: Diagnosis of HN depends on astute search for skin lesions, nerve thickening or tenderness, sensory or motor symptoms, histopathological examination, and demonstration of lepra bacilli.

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