01962nas a2200205   4500000000100000008004100001260001200042653001500054653001200069653001400081653001300095653001300108653001700121100001500138700001500153245006100168856008900229520142400318022001401742       2021                            d  c11/202110aArmadillos10aleprosy10aM. leprae10aNeuritis10aRifampin10aSchwann cell1 aEbenezer G1 aScollard D00aTreatment and Evaluation Advances in Leprosy Neuropathy.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8604554/pdf/13311_2021_Article_1153.pdf3 a<p>Neuropathy and related disabilities are the major medical consequences of leprosy, which remains a global medical concern. Despite major advances in understanding the mechanisms of M. leprae entry into peripheral nerves, most aspects of the pathogenesis of leprosy neuropathy remain poorly understood. Sensory loss is characteristic of leprosy, but neuropathic pain is sometimes observed. Effective anti-microbial therapy is available, but neuropathy remains a problem especially if diagnosis and treatment are delayed. Currently there is intense interest in post-exposure prophylaxis with single-dose rifampin in endemic areas, as well as with enhanced prophylactic regimens in some situations. Some degree of nerve involvement is seen in all cases and neuritis may occur in the absence of leprosy reactions, but acute neuritis commonly accompanies both Type 1 and Type 2 leprosy reactions and may be difficult to manage. A variety of established as well as new methods for the early diagnosis and assessment of leprosy neuropathy are reviewed. Corticosteroids offer the primary treatment for neuritis and for subclinical neuropathy in leprosy, but success is limited if nerve function impairment is present at the time of diagnosis. A candidate vaccine has shown apparent benefit in preventing nerve injury in the armadillo model. The development of new therapeutics for leprosy neuropathy is greatly needed.</p>
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