{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T19:13:24Z","timestamp":1783624404790,"version":"3.55.0"},"reference-count":45,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":176,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","award":["312802\/2020-0"],"award-info":[{"award-number":["312802\/2020-0"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004586","name":"Carlos Chagas Filho Foundation for Research Support of the State of Rio de Janeiro","doi-asserted-by":"publisher","award":["E-26\/204.201\/2024"],"award-info":[{"award-number":["E-26\/204.201\/2024"]}],"id":[{"id":"10.13039\/501100004586","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Brazil ranks second globally in leprosy burden, with approximately 25 000 cases reported in 2022. This study aimed to analyse the 26-year experience (1997\u20132023) in nerve biopsies at a specialized leprosy outpatient clinic, focusing on their usefulness in diagnosing peripheral neuropathy in patients with clinical and neurophysiological features suggestive of leprosy but lacking dermatological lesions. Tissue samples were preserved in glutaraldehyde, buffered formalin and liquid nitrogen, with histopathological analysis using various staining techniques and molecular testing on frozen material. In 819 cases, 529 were diagnosed with leprosy (64.6% overall leprosy diagnosis rate), and 207 pure neural leprosy cases were confirmed. Other conditions identified included vasculitis, diabetic neuropathy and amyloidosis, while 16.5% of cases yielded inconclusive results. The predominant clinical symptoms included sensory disorders (85.7%), localized paraesthesia (70.3%) and muscle weakness (59.4%), with multiple mononeuropathies frequently observed on electroneuromyography. The most biopsied nerves were the ulnar cutaneous branch (50.6%), sural (37.2%) and superficial peroneal (6.8%). Nerve biopsy proved valuable for confirming leprosy and distinguishing differential diagnoses in complex cases, particularly when clinical findings alone were insufficient. Integrating clinical\u2013pathological correlation optimized diagnostic accuracy, underscoring the importance of this tool in managing suspected neural leprosy and guiding treatment in challenging cases.<\/jats:p>","DOI":"10.1093\/braincomms\/fcag249","type":"journal-article","created":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T11:49:04Z","timestamp":1782388144000},"source":"Crossref","is-referenced-by-count":0,"title":["Peripheral nerve biopsy in pure neural leprosy: a 26-year experience in Brazil"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5553-4929","authenticated-orcid":false,"given":"Ana C","family":"Siquara-de-Sousa","sequence":"first","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]},{"name":"Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro , Rio de Janeiro 20270-004 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Hacker","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robson T","family":"Vital","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]},{"name":"Department of Neurology, Pedro Ernesto University Hospital, Rio de Janeiro State University , Rio de Janeiro 20551-900 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izabela J R","family":"Pitta","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]},{"name":"Department of Internal Medicine, Neurology, Fluminense Federal University , Niter\u00f3i 24033-900 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clarissa","family":"Spitz","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiane C","family":"Domingues","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna M","family":"Sales","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6059-0872","authenticated-orcid":false,"given":"Leila","family":"Chimelli","sequence":"additional","affiliation":[{"name":"Paulo Niemeyer State Brain Institute , Rio de Janeiro 20230-024 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio L G","family":"Antunes","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Euzenir N","family":"Sarno","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta O","family":"Pinheiro","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]},{"name":"Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation , Rio de Janeiro 21040-360 ,","place":["Brazil"]},{"name":"National Institute of Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia R","family":"Jardim","sequence":"additional","affiliation":[{"name":"Leprosy Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]},{"name":"Post-Graduate Program in Neurology, Federal University of the State of Rio de Janeiro , Rio de Janeiro 20270-004 ,","place":["Brazil"]},{"name":"Department of Neurology, Pedro Ernesto University Hospital, Rio de Janeiro State University , Rio de Janeiro 20551-900 ,","place":["Brazil"]},{"name":"Rio de Janeiro Research Network on Neuroinflammation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation , Rio de Janeiro 21040-360 ,","place":["Brazil"]},{"name":"National Institute of Science and Technology on Neuroimmunomodulation, Oswaldo Cruz Institute, Oswaldo Cruz Foundation (FIOCRUZ) , Rio de Janeiro 21040-360 ,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"issue":"2","key":"2026070914264858700_fcag249-B1","doi-asserted-by":"crossref","first-page":"338","DOI":"10.1128\/CMR.19.2.338-381.2006","article-title":"The continuing challenges of leprosy","volume":"19","author":"Scollard","year":"2006","journal-title":"Clin Microbiol 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