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ORIGINAL RESEARCH article
Front. Trop. Dis.
Sec. Neglected Tropical Diseases
Volume 6 - 2025 | doi: 10.3389/fitd.2025.1560079
This article is part of the Research Topic Enhancing Leprosy Diagnosis: New Tools and Approaches for Global Health Impact View all 3 articles
Evaluation of pulse therapy with intravenous methylprednisolone on leprosy neuritis in a Brazilian referral center
Provisionally accepted
Diogo Santos 1,2*
Pedro Henrique Sirotheau Corrêa 2 Fernanda de Oliveira Cirino 2
Leonardo Peixoto Garcia 1
João Paulo Moreira Fernandes 1
Douglas Eulálio Antunes 1
Isabela Maria Bernardes Goulart 1,2- 1 National Reference Center for Sanitary Dermatology and Leprosy, Clinics’ Hospital, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, Brazil, Uberlândia, Minas Gerais, Brazil
- 2 Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, Minas Gerais, Brazil
Background: Leprosy neuritis (LN) is an immune hyperactivity majorly responsible for the deformities and sequelae present in leprosy disease. This observational study aimed to evaluate the use of intravenous methylprednisolone in refractory LN cases in a national reference center of leprosy in Brazil. Methods: Epidemiological and clinical data were collected, and the following instruments were used on evaluation: visual analog pain scale (VAS), Douler Neuropathic 4 questionnaire (DN4), Screening of Activity Limitation and Safety Awareness (SALSA), and the simplified neurological assessment protocol by the Brazilian Ministry of Health. The initial and final results of pulse therapy were compared. Results: We included 18 patients. After pulse therapy, there was no difference regarding sensory and motor scores. At the beginning of the treatment, 66.7% (12/18) of patients were using oral prednisone at 35.0 mg (±12.43). After treatment, 38.9% (7/18) of them maintained oral prednisone at a lower dose (16.4mg ±6.3; p=0.002). Salsa score improved after treatment (p=0.020) and DN4 scores dropped from 6.7 (±1.7) to 5.2 (±2.1) (p<0.0001). Conclusion: Pulse therapy with endovenous methylprednisolone in LN was effective in decreasing pain intensity, preventing worsening of sensory-motor function, and reducing the dose of corticosteroids, reflecting the patient's improvement of functionality.
Keywords: Leprosy, peripheral neuropathy, Leprosy reaction, leprosy neuritis, Methylprednisolone, neuropathic pain
Received: 13 Jan 2025; Accepted: 24 Mar 2025.
Copyright: © 2025 Santos, Corrêa, Cirino, Garcia, Fernandes, Antunes and Goulart. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Diogo Santos, National Reference Center for Sanitary Dermatology and Leprosy, Clinics’ Hospital, School of Medicine, Federal University of Uberlândia (UFU), Uberlândia, Brazil, Uberlândia, Minas Gerais, Brazil
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