Abstract
Objective: To review the literature, including a clinical case discussion with suspicion of pure neural leprosy and final diagnosis of amyloid neuropathy. Methods: The study was conducted on May 28, 2020. A systematic review of the literature was conducted, with searches in PubMed, Medline, Lilacs and BVS MS using the descriptors: neuritic leprosy, pure neural leprosy, primary neural leprosy, pure neuritic leprosy, amyloid polyneuropathy, amyloid neuropathies, amyloid polyneuropathy. Clinical trials, cohorts, cross-sectional, clinical cases and case studies, published in Portuguese, English or Spanish between 2010 and 2020 were included. Then, a case report with an initial suspicion of pure neural leprosy was presented. Laboratory tests, electroneuromyography, ultrasound and biopsy of the sural nerve were requested. Results: 23 scientific texts were included. No publications with the two themes together were found. Diagnosis of pure neural leprosy and the possibility of using auxiliary resources were the most prominent themes in the studies. In the clinical case, the patient’s electroneuromyography showed sensitive and motor polyneuropathy of lower limbs, symmetrical, of moderate intensity, of the mixed type (axono- demyelinating), sensitive and axonal. Ultrasonography of the sural nerve revealed changes in the contour of the deep fibular nerves and biopsy of the sural nerve demonstrated the accumulation of amorphous eosinophilic material in the nerve path and Congo red staining showed birefringence of the deposit in applegreen under polarized light. The final diagnosis was amyloidotic neuropathy. Conclusion: Clinical diagnosis was amyloidotic neuropathy. Diagnosis of pure neural leprosy in endemic areas of Brazil is a challenge for the health system.
Highlights
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack
The present review study aimed to address the mechanisms of action of capsaicin and other chemical inducers in mast cell degranulation and an interaction of nerves and events that happen in the dura mater with the activation of mast cells
Conclusion: the analyzed data indicate that the polymorphisms contributed to the susceptibility to Parkinson’s disease (PD), further studies related to the polymorphisms and their relationship to PD are still needed for more ethnic groups, and early diagnosis is possible
Summary
Capsaicin is able to induce mast cell degranulation, an event probably related to the pathophysiology of a migraine attack. Methods: A literature review and an observational, descriptive and transversal data collect on treatment for acute demyelinating polyradiculoneuritis, available at DATASUS from January 2008 to December 2020, and articles available at Scielo and PubMed. Results: There were 7,917 hospitalizations, representing a total expenditure of R$ 9,392,552.04, 2009 being the year with the highest number of hospitalizations (809) and 2017 with the highest amount spent during the period (R$ 967,284.65). Methods: A literature review and an observational, descriptive and transversal data collect on surgical treatment was carried out, available from January 2008 to December 2020 and articles available in Scielo, Lilacs and PubMed. Results: There were 15,148 hospitalizations for surgical procedures for the treatment of chronic subdural hematoma, representing a total expenditure of R$ 45,365,258.21, with 2018 being the year with the highest number of hospitalizations (1,418) and with the highest amount spent during the period (R$ 4,570,334.28). Conclusions: The “Coca-Cola Bottle sign” is a classic sign of Graves’ disease, some signs, such as, unilateral and single orbital musculature involvement, may be suggestive of involvement by other etiologies, suggesting the benefit of an early expanded investigation
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