Clinical and laboratory studies of arthritis in leprosy.

Atkin, S. L.; El‐Ghobarey, A. F.; Kamel, M; Owen, J. P.; Dick, W C

doi:10.1136/bmj.298.6685.1423

Cited by 40 publications

(24 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, other studies have reported high frequencies of RF in leprosy, varying from 35 up to 60% (5,10,12,32). This discrepancy could be explained partially by a number of factors, including the type of assay utilized, study population, and possible role of different treatment regimens (31).…”

Section: Sle Ribeiro Et Almentioning

confidence: 63%

Anti-cyclic citrullinated peptide antibodies and rheumatoid factor in leprosy patients with articular involvement

Ribeiro

Pereira

Silva

et al. 2008

Braz J Med Biol Res

View full text Add to dashboard Cite

The objective of the present research was to evaluate the usefulness of anti-cyclic citrullinated peptide (anti-CCP) antibodies and the IgM rheumatoid factor (IgM RF) test for the differential diagnosis of leprosy with articular involvement and rheumatoid arthritis (RA). Anti-CCP antibodies and IgM RF were measured in the sera of 158 leprosy patients (76 with and 82 without articular involvement), 69 RA patients and 89 healthy controls. Leprosy diagnosis was performed according to Ridley and Jopling classification criteria and clinical and demographic characteristics of leprosy patients were collected by a standard questionnaire. Leprosy patients with any concomitant rheumatic disease were excluded. Serum samples were obtained from all participants and frozen at -20°C. Measurement of anti-CCP antibodies and IgM RF were performed by ELISA, using a commercial second-generation kit, and the latex agglutination test, respectively. Anti-CCP antibodies and IgM RF were detected in low frequencies (2.6 and 1.3%, respectively) in leprosy patients and were not associated with articular involvement. Among healthy individuals both anti-CCP antibodies and IgM RF were each detected in 3.4% of the subjects. In contrast, in the RA group, anti-CCP antibodies were present in 81.2% and IgM RF in 62.3%. In the present study, both anti-CCP antibodies and IgM RF showed good positive predictive value for RA, helping to discriminate between RA and leprosy patients with articular involvement. However, anti-CCP antibodies were more specific for RA diagnosis in the population under study.

show abstract

Section: Sle Ribeiro Et Almentioning

confidence: 63%

Anti-cyclic citrullinated peptide antibodies and rheumatoid factor in leprosy patients with articular involvement

Ribeiro

Pereira

Silva

et al. 2008

Braz J Med Biol Res

View full text Add to dashboard Cite

show abstract

“…Rheumatological manifestations of leprosy involve skin, articular and soft tissues. 4 Arthritis predominantly involved the small joints of hands and resolved by 4 weeks in most patients. Type 1 lepra reaction usually manifests with exacerbation of the previously existing lesions.…”

Section: Discussionmentioning

confidence: 96%

“…8 However, Alcocer et al found arthritis in 12/18 (78%). 4 Two recent Indian studies observed the prevalence rates for arthritis in leprosy as 61.4% and 10%, respectively. 4 Two recent Indian studies observed the prevalence rates for arthritis in leprosy as 61.4% and 10%, respectively.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Leprosy revealed in a rheumatology clinic: A case series

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Reactional states may present as acute or chronic polyarthritis. [26][27][28][29] Radiographies of the limbs in these patients reveal erosion and subluxation, 26 as well as phalangeal pseudocysts, collapse and cupping of joint surfaces. 3 Systemic manifestations may precede the appearance of cutaneous lesions, causing difficulties in diagnosis.…”

Section: Extracutaneous Manifestations and Laboratory Findingsmentioning

confidence: 99%

Contribuição ao diagnóstico e manejo dos estados reacionais: Uma abordagem prática

Nery¹,

Sales²,

Illarramendi³

et al. 2006

An. Bras. Dermatol.

View full text Add to dashboard Cite

Abstract:The early clinical recognition of reactional states brings great benefits to leprosy patients due to the possibility of appropriate and immediate therapeutic intervention, thus avoiding the development of disabilities that so much stigmatize and complicate the disease. There are three types of reactional episodes: types 1, 2 and neuritis. The latter may occur alone or together with the former forms. In some cases only neurological and/or skin manifestations are observed in the reactions; in others, patients present systemic alterations. The treatment with an association of immunosuppressors and anti-inflammatory drugs seems to be the most effective to avoid recurrences and side effects. INTRODUCTIONLeprosy would not have major repercussions during its progression if there were not reactional episodes. The aim of this review is to provide theoretical support for improved understanding and management of these episodes to decrease morbidity and clinical consequences. CONCEPTReactional states are immunoinflammatory events presenting almost always as local or systemic dermatological and neurological manifestations that occur at distinct moments (before, during or after the specific treatment of leprosy) and that require immediate intervention. CLASSIFICATIONThere are three clinical presentations of reactional states. Type I is the reverse reaction (RR) that occurs mostly in patients with borderline tuberculoid (BT), borderline-borderline (BB) and borderline lepromatous (BL) forms.1 This reaction occurs very seldom in the lepromatous-lepromatous type (LL). Type II, erythema nodosum leprosum (ENL), occurs in patients with LL and BL. A third type of reaction, named isolated neuritis, is a reactional state which presents as pain (spontaneous or promoted by compression of a nerve trunk), accompanied or not by nerve thickening, with no dermatological features of types I or II.2 Nery et al. found seven cases of isolated neuritis in 100 multibacillary (MB) patients with reactional states. The frequency of isolated neuritis was 57.1% in the BB form, 28.6% in the BL form and 4.3% in LL patients. 3 TYPE I REACTION: REVERSAL REACTION PathophysiologyReversal reaction (RR) or type I reaction is an event that follows a sudden development of cell mediated immunity; it is considered a transitory state directed towards the tuberculoid type, sometimes with positive lepromin skin tests and formation of epithelioid granulomas. The presentation may vary with the clinical form (Chart 1). Usually reactivation of preexisting lesions or the appearance of new lesions in previously healthy areas with erythema and infiltration are observed, forming a smooth and bright plaque with an edematous surface, which may regress with scaling and residual hyperchromia. The reactional state may last weeks or months.The mucosa and semimucosa may also be affected, as well as the skin. A burning sensation in cutaneous lesions, facial or extremity pain, paresthesis, decreased sensitivity and reduced muscular strength may be present. 4,5Clinical varia...

show abstract

Clinical and laboratory studies of arthritis in leprosy.

Cited by 40 publications

References 18 publications

Anti-cyclic citrullinated peptide antibodies and rheumatoid factor in leprosy patients with articular involvement

Anti-cyclic citrullinated peptide antibodies and rheumatoid factor in leprosy patients with articular involvement

Leprosy revealed in a rheumatology clinic: A case series

Contribuição ao diagnóstico e manejo dos estados reacionais: Uma abordagem prática

Contact Info

Product

Resources

About