Publication:
Neuritic Leprosy; An Intriguing Re-visit to a Forbidden Ailment

creativeworkseries.issn1812-2027
dc.contributor.authorShrestha, BK
dc.contributor.authorRanabhat, K
dc.contributor.authorPant, R
dc.contributor.authorSapkota, S
dc.contributor.authorShrestha, S
dc.date.accessioned2025-11-26T07:47:44Z
dc.date.available2025-11-26T07:47:44Z
dc.date.issued2019
dc.descriptionShrestha BK,1 Ranabhat K,2 Pant R,3 Sapkota S,1 Shrestha S1 1Department of Neurosurgery 2Department of Radiology 3Department of Pathology Upendra Devkota Memorial National Institute of Neurological and Allied Sciences, Bansbari, Kathmandu
dc.description.abstractABSTRACT Leprosy is a chronic infectious disease that presents with varied manifestations. Pure neuritic leprosy is one of the rarest forms of the disease which is characterized by nerve involvement without the characteristic cutaneous stigmata. Eleven year old, healthy male presented with progressively increasing painful swelling at the medial aspect of the arm near to the right elbow joint with difficulty in extending right ring and little fingers at interphalangeal joint and numbness in the same region for last 1 year with no cutaneous abnormalities. Physical examination revealed 6x3 cm firm, tender lesion 3 cm proximal to the right elbow joint with positive tinel’s sign, without signs of inflammation, along with characteristic claw hand deformity of right hand and atrophy of hypothenar and interossei muscle. Electro-diagnostic testing revealed findings consistent with a right ulnar axonal neuropathy above the elbow. Magnetic resonance imaging revealed well defined heterogeneously hyper intense linear lesion along the course of thickened ulnar nerve in the distal arm extending posterior to the medial condyle. It also showed an oval shaped lesion (2.1x1.0 cm) arising from the same segment of the nerve, without any bony or muscular involvement of that area. The patient underwent surgical exploration and ulnar nerve decompression with biopsy. Pathology revealed necrotizing granulomatous inflammatory acid fast bacilli stain negative lesion, which was histologically consistent with caseous abscess caused by tuberculoid leprosy, pathognomonic for Hansen’s disease. He has been started on antibiotic therapy and is referred to leprosy center for further course of management. Pure neuritic leprosy, though rare, should be considered as differential diagnosis in cases presenting with peripheral neuropathy at leprosy-endemic areas. Prompt diagnosis and treatment is imperative to prevent permanent neurological injury. KEY WORDS Leprosy, Neuropathy, Ulnar nerve
dc.identifier.urihttps://hdl.handle.net/20.500.14572/3273
dc.language.isoen_US
dc.publisherKathmandu University
dc.subjectLeprosy
dc.subjectNeuropathy
dc.subjectUlnar nerve
dc.titleNeuritic Leprosy; An Intriguing Re-visit to a Forbidden Ailment
dc.typeArticle
dspace.entity.typePublication
local.article.typeCase Report
oaire.citation.endPage76
oaire.citation.startPage73
relation.isJournalIssueOfPublication72dd99d7-b8e8-4029-ae15-e344cbdb688b
relation.isJournalIssueOfPublication.latestForDiscovery72dd99d7-b8e8-4029-ae15-e344cbdb688b
relation.isJournalOfPublicationa782b7ff-cf89-4178-ad1c-11ed89cfe1bd

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