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2013, Number 1

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Enf Infec Microbiol 2013; 33 (1)

Leprosy: pathology awareness based on historic consciousness

Muñoz ML, Constanza CL, Hernández BR, Navarrete J

Language: Spanish
References: 126
Page: 32-43
PDF size: 425.76 Kb.


ABSTRACT

Leprosy is a chronic infectious disease caused by Mycobacterium leprae. It affects the skin, mucosa of upper respiratory tracts, eyes and peripheral nerves. The incubation period of the disease is on average five years. Symptoms may take up to 20 years to appear. It is a very old disease, was recognized in the ancient civilizations of China, Egypt and India, around the year 600 BC. Currently there are areas with high incidence in Africa, Asia and Latin America. This article describes aspects of biological, immunological, and clinical diagnosis of Mycobacterium leprae, in order to generate greater interest and awareness against this social epidemiological problem.


REFERENCES

  1. 1.-Hansen GA. “On the etiology of leprosy”. Br Foreign Med-Chir Rev 1875; 55: 459-489.

  2. 2.-Hansen GHA. «Undersøgelser Angående Spedalskhedens Årsager (Investigaciones acerca de la etiología de la lepra)» en Noruego. Norsk Mag. Laegervidenskaben 1874; 4: 1-88.

  3. 3.-Corporación Social para la rehabilitación del enfermo. Informativo CORSOHANSEN 2010; 19: 1-4.

  4. 4.-Walsh GP, Storrs E, Burchfield H. “Leprosy-like disease occurring naturally in armadillos”. RES J Reticuloendothel Soc 1975; 18: 347-351.

  5. 5.-Hamilton HK, Levis WR, Martiniuk F, Cabrera A, Wolf J. “The role of the armadillo and sooty mangabey monkey in human leprosy”. Int J Dermatol 2008; 47: 545-550.

  6. 6.-Pedrini SC, Rosa PS, Medri IM, Mourão G, Bagagli E, Lopes CA. “Search for Mycobacterium leprae in wild mammals”. Braz J Infect Dis 2010; 14: 47-53.

  7. 7.-Gormus BJ, Wolf RH, Baskin GB, Ohkawa S, Gerone PJ, Walsh GP, et al. “A second sooty mangabey monkey with naturally acquired leprosy: first reported possible monkey-to-monkey transmission”. Int J Lepr Other Mycobact Dis 1988; 56: 61-65.

  8. 8.-Gormus BJ, Xu K, Baskin GB, Martin LN, Bohm RP Jr, Blanchard JL, et al. “Experimental leprosy in rhesus monkeys: transmission, susceptibility, clinical and immunological findings”. Lepr Rev 1998; 69: 235-245.

  9. 9.-World Health Organization. Weekly epidemiological record. 2009; 84: 333-340.

  10. 10.-Corporación Social para la rehabilitación del enfermo. Informativo CORSOHANSEN 2009; 16: 1-4.

  11. 11.-Draper P, Kandler O, Darbre A. “Peptidoglycan and arabinogalactan of Mycobacterium leprae”. J Gen Microbiol 1987; 133: 1187-1194.

  12. 12.-Mahapatra S, Crick DC, McNeil MR, Brennan PJ. “Unique structural features of the peptidoglycan of Mycobacterium leprae”. J Bacteriol 2008; 190: 655-661.

  13. 13.-McNeil M, Daffe M, Brennan PJ. “Evidence for the nature of the link between the arabinogalactan and peptidoglycan of mycobacterial cell walls”. J Biol Chem 1990; 265: 18200-18206.

  14. 14.-Lee RE, Li W, Chatterjee D, Lee RE. “Rapid structural characterization of the arabinogalactan and lipoarabinomannan in live mycobacterial cells using 2D and 3D HR-MAS NMR: structural changes in the arabinan due to ethambutol treatment and gene mutation are observed”. Glycobiology 2005; 15: 139-151.

  15. 15.-Melancon-Kaplan J, Hunter SW, McNeil M, Stewart C, Modlin RL, Rea TH, et al. “Immunological significance of Mycobacterium leprae cell walls”. Proc Natl Acad Sci USA 1988; 85: 1917-1921.

  16. 16.-Crick DC, Mahapatra S, Brennan PJ. ”Biosynthesis of the arabinogalactan-peptidoglycan complex of Mycobacterium tuberculosis”. Glycobiology 2001; 11: 107R-118R.

  17. 17.-Monot M, Honoré N, Garnier T, Zidane N, Sherafi D, Paniz-Mondolfi A, et al. «Comparative genomic and phylogeographic analysis of Mycobacterium leprae”. Nat Genet 2009; 41: 1282-89.

  18. 18.-Wheeler PR. “Biosynthesis and Scavenging of Purines by Pathogenic Mycobacteria Including Mycobacterium leprae”. J Gen Microbiol 1987; 133: 2999-3011.

  19. 19.-Dawes SS, Mizrahi V. “DNA metabolism in Mycobacterium leprae”. Lepr Rev 2001; 72: 408-414.

  20. 20.-Honore N. “The Mycobacterium leprae genome: from sequence analysis to therapeutic implications”. Med Trop (Mars). 2002; 62: 473-479.

  21. 21.-Cole ST, Eiglmeier K, Parkhill J, James KD, Thomson NR, Wheeler PR, et al. “Massive gene decay in the leprosy bacillus”. Nature 2001; 409: 1007-1011.

  22. 22.-Brosch R, Grodon SV, Eiglmeier K, Garnier T, Cole ST. “Comparative genomics of the leprosy and tubercule bacilli”. Res Microbiol 2000; 151: 135–142.

  23. 23.-Eiglmeier K, Parkhill J, Honore N, Garnier T, Tekaia F, Telenti A, et al. “The decaying genome of Mycobacterium leprae”. Lepr Rev 2001; 72: 387–398.

  24. 24.-Vissa VD, Brennan PJ. “The genome of Mycobacterium leprae: a minimal mycobacterial gene set”. Genome Biol 2001; 2: 2-8.

  25. 25.-Truman RW, Krahenbuhl JL. “Viable M. leprae as a research reagent”. Int J Lepr Other Mycobact Dis 2001; 69: 1-12. Shepard CC. “The experimental disease that follows

  26. 26.-the injection of human leprosy bacilli into foot-pads of mice”. J Exp Med 1960; 112: 445-454. Krahenbuhl J, Adams LB. “Exploitation of gene

  27. 27.-knockout mice models to study the pathogenesis of leprosy”. Lepr Rev 2000; 71Suppl: S170-175.

  28. 28.-Hastings RC, Gillis TP, Krahenbuhl JL, Franzblau SG. “Leprosy”. Clin Microbiol Rev 1988; 1: 330-348.

  29. 29.-Eiglmeier K, Simon S, Garnier T, Cole ST. “The integrated genome map of Mycobacterium leprae”. Lepr Rev 2001; 72: 462-469.

  30. 30.-Wheeler PR. “The microbial physiologist’s guide to theleprosy genome”. Lepr Rev 2001; 72: 399-407.

  31. 31.-Cole ST. “The Mycobacterium leprae genome Project”. Int J Lepr Other Mycobact Dis 1998; 66: 589-591.

  32. 32.-The Institute for Genomic Research [http: //www.tigr.org]

  33. 33.-Rees RJW, McDougall AC. “Airborne infection with Mycobacterium leprae in mice”. J Med Microbiol 1977; 10: 63-68.

  34. 34.-Visschedijk J, van de Broek J, Eggens H, Lever P, van Beers S, Klatser P. “Mycobacterium leprae-millennium resistant! Leprosy control on the threshold of a new era”. Trop Med Int Health 2000; 5: 388-399.

  35. 35.-Job CK, Jayakumar J, Kearney M, Gillis TP. “Transmission of leprosy: a study of skin and nasal secretions of household contacts of leprosy patients using PCR”. Am J Trop Med Hyg 2008; 78: 518-521.

  36. 36.-Walker SL, Lockwood DNJ. “The clinical and immunological features of leprosy”. Br Med Bull, 2006; 77-78: 103-121.

  37. 37.-Argaw AT, Shannon EJ, Assefa A, et al. “A geospatial risk assessment model for leprosy in Ethiopia based on environmental thermal-hydrological regime analysis”. Geospatial Health, 2006; 1: 105-113.

  38. 38.-Naafs B, Silva E, Vilani-Moreno F, Marcos EC, et al. “Factors influencing the development of leprosy: an overview”. Int J Lepr 2001; 69: 27-33.

  39. 39.-Ghorpade A. “Inocculation (tattoo) leprosy: a report of 31 cases”. J Eur Acad Dermatol Venereol 2002; 16: 494-496.

  40. 40.-Brandsma JW, Yoder LJ, Macdonald M. “Leprosy acquired by inoculation from a knee injury”. Lepr Rev, 2005; 76: 175-178.

  41. 41.-Khanolkar VR. “Pathology of leprosy”. En: Cochrane RG, Davey TF (Eds). Leprosy in theory and practice, 2a Ed. John Wright and Sons Ltd, Bristol, UK, 1964: 125-151.

  42. 42.-Scollard DM. “Endothelial cells and the pathogenesis of lepromatous neuritis: insights from the armadillo model”. Microbes Infect 2000; 2: 1835-1843. 43.-Matsumoto K, Yajima M, Asano G. “Pathological findings of the liver in Hansen’s disease”. Nihon Hansenbyo Gakkai Zasshi 1997; 66: 97-102.

  43. 44.-Bernard JC, Vazquez CA. “Visceral lesions in lepromatous leprosy. Study of sixty necropsies.” Int J Lepr Other Mycobact Dis 1973; 41: 94-101.

  44. 45.-Neena K, Ammini AC, Singh M, Pandhi RK. “Ovarian function in female patients with multibacillary leprosy”. Int J Lepr Other Mycobact Dis 2003; 71: 101-105.

  45. 46.-Murthy PK. “Clinical manifestations, diagnosis and classification of leprosy”. J Indian Med Assoc 2004; 102: 678-679.

  46. 47.-Merzenich MM, Jenkins WM. “Reorganization of cortical representations of the hand following alterations of skin inputs induced by nerve injury, skin island transfers, and experience”. J Hand Ther 1993; 6: 89-104.

  47. 48.-Malaviya GN. “Sensory perception in leprosy-neurophysiological correlates”. Int J Lepr Other Mycobact Dis 2003; 71: 119-124.

  48. 49.-Bhatheja K, Field J. “Schwann cells: origins and role in axonal maintenance and regeneration”. Int J Biochem Cell Biol 2006; 38: 1995-1999.

  49. 50.-Berti C, Nodari A, Wrabetz L, Feltri ML. “Role of Integrins in Peripheral Nerves and Hereditary neuropathies”. Neuromolecular Med 2006; 8: 191-204.

  50. 51.-Ng V, Zanazzi G, Timpl R, Talts JF, Salzer JL, Brennan PJ, et al. “Role of the cell wall phenolic glycolipid-1 in the peripheral nerve predilection of Mycobacterium leprae”. Cell 2000; 103: 511-524.

  51. 52.-Tapinos N, Rambukkana A. “Insights into regulation of human Schwann cell proliferation by Erk1/2 via a MEK-independent and p56Lck-dependent pathway from leprosy bacilli”. Proc Natl Acad Sci USA 2005; 102: 9188-9193.

  52. 53.-Mukherjee R. “Antia NH Host–parasite interrelationship between M. leprae and Schwann cells in vitro”. Int J Leprosy 1986; 54: 632-638.

  53. 54.-Pautas aprobadas en Manila publicadas como: “Epidemiologia e la lepra” Revista de Higiene 1932; 13: 13-19.

  54. 55.-Ridley DS, Jopling WH. “A classification of leprosy for research purposes”. Lepr Rev 1962; 33: 119-128.

  55. 56.-Ridley DS, Jopling WH. “Classification of leprosy according to immunity. A five-group system.” Int J Leprosy 1966; 34: 255-273.

  56. 57.-83. Ridley DS, Jopling WH. “Classification of leprosy according to immunity: a five-group system”. Int J Lepr Other Mycobact Dis 1966; 34: 255–273.

  57. 58.-Yamamura M, Wang XH, Ohmen JD, Uyemura K, Rea TH, Bloom BR, et al. “Cytokine patterns of immunologically mediated tissue damage”. J Immunol 1992 ; 149: 1470-1475.

  58. 59.-Cardoso CC, Pereira AC, Brito-de-Souza VN, Dias-Baptista IM, Maniero VC, Venturini J, et al. “IFNG +874 T>A single nucleotide polymorphism is associated with leprosy among Brazilians”. Hum Genet 2010; 128: 481-490.

  59. 60.-Venturini J, Soares CT, Belone Ade F, Barreto JA, Ura S, Lauris JR, et al. “In vitro and skin lesion cytokine profile in Brazilian patients with borderline tuberculoid and borderline lepromatous leprosy”. Lepr Rev 2011; 82: 25-35.

  60. 61.-Matsuo C, Talhari C, Nogueira L, Rabelo RF, Santos MN, Talhari S. “Borderline lepromatous leprosy”. An Bras Dermatol 2010; 85: 921-922.

  61. 62.-Foss NT. “Hanseniase: aspectos clínicos, imunológicos e terapêuticos”. An Bras Dermatol 1999; 74: 113-119.

  62. 63.-Britton WJ, Lockwood DN. “Leprosy”. Lancet. 2004; 363: 1209-1219.

  63. 64.-Cho SN, Cellona RV, Villahermosa LG, Fajardo TT Jr, Balagon MV, Abalos RM, et al. “Detection of phenolic glycolipid I of Mycobacterium leprae in sera from leprosy patients before and after start of multidrug therapy”. Clin Diagn Lab Immunol 2001; 8: 138-142.

  64. 65.-Chimenos Küstner E, Pascual Cruz M, Pinol Dansis C, Vinals Iglesias H, Rodríguez de Rivera Campillo ME, López López J. “Lepromatous leprosy: a review and case report”. Med Oral Patol Oral Cir Bucal 2006,11: E474-479.

  65. 66.-WHO expert committee on leprosy, seventh report, WHO technical report series. WHO: Geneva; 1998; 1-43.

  66. 67.-Rea TH, Modlin RL: “Immunopathology of leprosy skin lesions”. Semin Dermatol 1991; 10: 188-193.

  67. 68.-Kahawita IP, Lockwood DNJ. ”Towards understanding the pathology or erythema nodosum leprosum”. Trans R Soc Trop Med Hyg 2008; 102: 329-337.

  68. 69.-Ramesh V, Pahwa M. “Some unusual type 2 reactions in leprosy”. Int J Dermatol 2010; 49: 172-175.

  69. 70.-Jacob JT, Kozarsky P, Dismukes R, Bynoe V, Margoles L, Leonard M, et al. “Five-year experience with type 1 and type 2 reactions in Hansen disease at a US travel clinic”. Am J Trop Med Hyg 2008; 79: 452-454.

  70. 71.-Vieira LM, Sampaio EP, Nery JA, et al. “Immunological status of ENL (erythema nodosum leprosum) patients: Its relationship to bacterial load and levels of circulating IL-2R”. Rev Inst Med Trop Sao Paulo. 1996; 38: 103-111.

  71. 72.-Kumar B, Dogra S, Kaur I. ”Epidemiological characteristics of leprosy reactions: 15 years experience from north India”. Int J Lepr Other Mycobact Dis 2004; 72: 125-133.

  72. 73.-Kahawita IP, Lockwood DN. “Towards understanding the pathology of erythema nodosum leprosum”. Trans R Soc Trop Med Hyg 2008; 102: 329-337.

  73. 74.-Cuevas J, Rodríguez-Peralto JL, Carrillo R, Contreras F. “Erythema nodosum leprosum: reactional leprosy”. Semin Cutan Med Surg 2007; 26: 126-130.

  74. 75.-Lucio R, Alvarado I. “Opúsculo sobre el mal de San Lázaro o Elefanciasis de los Greigos”. M. Murguía y cía., México 1852: citado por Latapí y Chevez Zamoro.

  75. 76.-Benard G, Sakai-Valente NY, Bianconcini Trindade MA. “Concomitant lucio phenomenon and erythema nodosum in a leprosy patient: clues for their distinct pathogeneses”. Am J Dermatopathol 2009; 31: 288-292.

  76. 77.-Mège JL, Mehraj V, Capo C. “Macrophage polarization and bacterial infections”. Curr Opin Infect Dis 2011, 24:

  77. 230-234.

  78. 78.-Medzhitov R, Shevach EM, Trinchieri G, Mellor AL, Munn DH, Gordon S, et al. “Highlights of 10 years of immunology”. Nat Rev Immunol 2011; 11: 693-702.

  79. 79.-Bjorkman PL. “Structure of the human class I histocompatibility antigens”. Nature 1987; 329: 506-512.

  80. 80.-Cardoso CC, Pereira AC, de Sales Marques C, Moraes MO. “Leprosy susceptibility: genetic variations regulate innate and adaptive immunity, and disease outcome”. Future Microbiol 2011; 6: 533-549.

  81. 81.-Lagrange PH, Abel L. “The genetic susceptibility to leprosy in humans” [artículo en francés]. Acta Leprol 1996; 10: 11-27.

  82. 82.-Kumar S, Naqvi RA, Khanna N, Rao DN. “Disruption of HLA-DR raft, deregulations of Lck-ZAP-70-Cbl-b crosstalk and miR181a towards T cell hyporesponsiveness in leprosy”. Mol Immunol 2011; 48: 1178-1190.

  83. 83.-Mosmann TR, Coffman RL. “Thl and Th2 cells: different patterns of lymphokine secretion lead to different functional properties”. Ann Rev Immunol 1989; 7: 145-174.

  84. 84.-Bloom BR, Salgame P, Diamond B. “Revisiting and revising suppressor T cells”. Immunol Today 1992; 13: 131-136.

  85. 85.-Salgame P, Abrams JS, Clayberger C, Goldstein H, Convit J, Modlin RL, et al. “Differing lymphokine profiles of functional subsets of human CD4 and CD8 T-cell clones”. Science 1991; 254: 279-282.

  86. 86.-Yamamura M, Uyemura K, Deans RJ, Weinberg K, Rea TH, Bloom BR, et al. “Defining protective responses to pathogens: cytokine profiles in leprosy lesions”. Science 1991; 254: 277-279.

  87. 87.-Mutis T, Kraakma EM, Comelisse YE, Haanen JBAG, Spits H, De Vries RRP, et al. ”Analysis of cytokine production by Mycobact-erium-reactive T cells. Failure to explain Mycobacterium leprae-specific non responsiveness of peripheral blood T cells from lepromatous leprosy patients”. J Immunol 1993; 150: 4641-4651.

  88. 88.-Tabouret G, Astarie-Dequeker C, Demangel C, Malaga W, Constant P, Ray A, et al. “Mycobacterium leprae phenolglycolipid-1 expressed by engineered M. bovis BCG modulates early interaction with human phagocytes”. Cell Host Microbe 2009; 6: 343-353.

  89. 89.-Teles RMB, Krutzik SR, Ochoa MT, Oliveira RB, et al.“Modlin Interleukin-4 Regulates the Expression of CD209 and Subsequent Uptake of Mycobacterium leprae by Schwann Cells in Human Leprosy”. Infect Immun 2010; 78: 4634-4643.90.-Mahon AC, Nurlign A, Kebede B, Becx-Bleumink M,

  90. Lefford MJ. “Urinary phenolic glycolipid 1 in the diagnosis and management of leprosy”. J Infect Dis 1991; 163: 653-656.

  91. 91.-Spencer JS, Kim HJ, Wheat WH, Chatterjee D, Balagon MV, Cellona V, et al. “Analysis of antibody responses to Mycobacterium leprae phenolic glycolipid I, lipoarabinomannan, and recombinant proteins to define disease subtype-specific antigenic profiles in leprosy”. Clin Vaccine Immunol 2011; 18: 260-267

  92. 92.-Nagao-Dias A, Almeida L, Oliveira M, Santos R, Lima A, Brasil M. “Salivary anti-PGL IgM and IgA titers and serum antibody IgG titers and avidities in leprosy patients and their correlation with time of infection and antigen exposure”. Braz J Infect Dis 2007; 11: 215-219.

  93. 93.-Convit J, Ulrich M. “Leprosy: Bacterial, pathological, immunological and immu-nopathological aspects”. En: Mycobacterial Skin Diseases, Ed. M. Harahap, Kluwer Academic Publishers, Lancashire, 1989: 33-78.

  94. 94.-McDougall AC, Ulrich M. “Mycobacterial Disease: Leprosy.” En: Dermatology in General Medicine, 4a Ed., TB Fitzpatrick, et al (Eds.), Nueva York, McGraw-Hil, 1993: 2395-2410.

  95. 95.-Clark-Curtiss JE, Walsh GP. “Conservation of genomic sequences among isolates of Mycobacterium leprae”. J Bacteriol 1989; 171: 4844-4851. Schlesinger LS, Horwitz MA. “Phenolic glycolipid 1 of 96.-Mycobacterium leprae binds complement component C3 in serum and mediates phagocytosis by human monocytes”. J Exp Med 1991; 174: 1031-1038.

  96. 97.-Jadhav R, Suneetha L, Kamble R, Shinde V, Devi K, Vani M, et al. “Analysis of Antibody and Cytokine Markers for Leprosy Nerve Damage and Reactions in the INFIR Cohort in India”. PLoS Negl Trop Dis 2011; 5: e977.

  97. 98.-Sampaio LH, Stefani M, Oliveira R, Sousa A, Ireton G, Reed S, et al. “Immunologically reactive M. leprae antigens with relevance to diagnosis and vaccine development”. BMC Infec Dis 2011; 11: 26-36.

  98. 99.-Mustafa AS, Lundin KE, Meloen RH, Shinnick TM, Coulson AF. “Oftung FHLA-DR4-restricted T-cell epitopes from the mycobacterial 60 000 MW heat shock protein (hsp 60) do not map to the sequence homology regions with the human hsp 60”. Immunology 1996; 87: 421-427.

  99. 100.-Patil SA, Girdhar BK, Singh KP, Sengupta U. “Detection ycobacterium leprae antigens in the sera of leprosy patients by sandwich immunoradiometric assay using monoclonal antibodies”. J Clin Microbiol 1990; 28: 2792-2796. 101.-Lockwood DN, Colston MJ, Khanolkar-Young SR. “The detection of Mycobacterium leprae protein and carbohydrate antigens in skin and nerve from leprosy patients with type 1 (reversal) reactions”. Am J Trop Med Hyg 2002; 66: 409-415.

  100. 102.-Buhrer-Sekula S, Smits HL, Gussenhoven GC, van Leeuwen J, Amador S, Fujiwara T, et al. “Simple and fast lateral flow test for classification of leprosy patients and identification of contacts with high risk of developing leprosy”. J Clin Microbiol 2003; 41: 1991-1995.

  101. 103.-Nicholls PG, Ross L, Smith WC. “Promoting early detection in leprosy–a literature review to identify proven and potential interventions addressing patient-related delay”. Lepr Rev 2006; 77: 298-310.

  102. 104.-Lockwood DN, Suneetha S. “Leprosy: too complex a disease for a simple elimination paradigm”. Bull World Health Organ 2005; 83: 230-235.

  103. 105.-Moura RS, Calado KL, Oliveira ML, Bührer-Sékula S. “Leprosy serology using PGL-I: a systematic review”. Rev Soc Bras Med Trop 2008; 41 Suppl 2: 11-18.

  104. 106.-Roche PW, Theuvenet WJ, Britton WJ. “Risk factors for type-1 reactions in borderline leprosy patients”. Lancet 1991; 338: 654-657.

  105. 107.-Bührer-Sékula S. “PGL-I leprosy serology”. Rev Soc Bras Med Trop 2008; 41 Suppl 2: 3-5.

  106. 108.-Buhrer SS, Smits HL, Gussenhoven GC, van Ingen CW, Klatser PR. “A simple dipstick assay for the detection of antibodies to phenolic glycolipid-I of Mycobacterium leprae”. Am J Trop Med Hyg 1998; 58: 133-136.

  107. 109.-Buhrer-Sekula S, Smits HL, Gussenhoven GC, van Leeuwen J, Amador S, Fujiwara T, et al. “Simple and fast lateral flow test for classification of leprosy patients and identification of contacts with high risk of developing leprosy”. J Clin Microbiol 2003; 41: 1991-1995.

  108. 110.-Stefani MM, Martelli CM, Morais-Neto OL, Martelli P, Costa MB, de Andrade AL. “ Assessment of anti-PGL-I as a prognostic marker of leprosy reaction”. Int J Lepr Other Mycobact Dis 1998; 66: 356-364.

  109. 111.-Mshana RN, Belehu A, Stoner GL, et al. “Demonstration of mycobacterial antigens in leprosy tissues”. Int J Lepr 1982; 50: 1-9.

  110. 112.-Rodrigues LC, Lockwood DNj. “Leprosy now: epidemiology, progress, challenges, and research gaps”. Lancet Infect Dis 2011; 11: 464-470.

  111. 113.-Sampaio LH, Stefani MM, Oliveira RM, Sousa AL, Ireton GC, Reed SG, et al. “Immunologically reactive M. leprae antigens with relevance to diagnosis and vaccine development”. BMC Infect Dis 2011; 11: 26.

  112. 114.-Maeda SM, Rotta O, Michalany NS, Camargo ZP, Sunderkötter C, Tomimori-Yamashita J. “Comparison between anti-PGL-I serology and Mitsuda reaction: clinical reading, microscopic findings and immunohistochemical analysis”. Lepr Rev 2003; 74: 263-274.

  113. 115.-Azulay RD, Azulay DR. Dermatología. 2a Ed. Río de Janeiro, Guanabara Koogan,1997: 174-189.

  114. 116.-Goulart IM, Goulart LR. “Leprosy: diagnostic and control challenges for a worldwide disease”. Arch Dermatol Res 2008; 300: 269-290.

  115. 117.-Bhatia A, Katoch K, Narayanan R, et al. “Clinical and histopathological correlation in the classification of leprosy”. Int J Lepr 1993; 61: 433-438.

  116. 118.-Ramos-e-Silva M, Rebello PF. “Leprosy. Recognition and treatment”. Am J Clin Dermatol 2001; 2: 203-211.

  117. 119.-Teixeira AC, Cruvinel DL, Roma FR, Luppino LF, Resende LHP, Sousa T, et al. “Avaliação da concordância entre exames clínicos e laboratoriais no diagnóstico da hanseníase”. Hansenol Int 2005; 30: 89.

  118. 120.-Shi L, Yajima M, Kawatsu K, Matsuoka M, Kashiwabara Y. “Comparison of polymerase chain reaction, immunohistochemistry and conventional histopathology in the diagnosis of early leprosy in Sichuan Province of China”. Jpn J Lepr 2000; 69: 147-155.

  119. 121.-Williams DL, Scollard DM, Gillis TP. “PCR-based diagnosis of leprosy in the United States”. Clin Mcrobiol Newslett 2003; 25: 57-61.

  120. 122.-Phetsuksiri B, Rudeeaneksin J, Supapkul P, Wachapong S, Mahotarn K, Brennan PJ. “A simplified reverse transcriptase PCR for rapid detection of Mycobacterium leprae in skin specimens”. FEMS Immunol Med Microbiol 2006; 48: 319-328.

  121. 123.-Pereira HLA, Ribeiro SLE, Ciconelli RM, Fernandes ARC. “Imaging methods evaluation in osteoarticular and peripheral nerves involvement in leprosy”. Rev Bras Reumatol 2006; 46 Suppl1: 30-35.

  122. 124.-Martinoli C, Bianchi S, Dahmane M, Pugliese F, Bianchi- Zamorani M, Valle M. “Ultrasound of tendons and nerves”. Eur Radiol 2004; 12: 44-55.

  123. 125.-Hari S, Subramanian S, Sharma R. “Magnetic resonance imaging of ulnar nerve abscess in leprosy: a case report”. Lepr Rev 2007; 78: 155-159.

  124. 126.-Faget GH, Johansen FA, Ross H. “Sulfanilamide in thetreatment of leprosy”. Public Health Rep 1942; 57: 1892-1899.

  125. 127.-World Health Organization. “Chemotherapy of leprosy for control programmes”. WHO Tech Rep Ser 1982: 675.

  126. 128.-Terencio de las Aguas J. “Estado actual de la terapéutica de la lepra”. DCMQ 2008; 6: 118-125.




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