Lepromatous leprosy simulating rheumatoid arthritis - Report of a neglected disease

Abstract

Brazil has the second largest number of leprosy cases in the world; nevertheless, late diagnosis is common. We report the case of a male patient with pain and numbness in both hands and feet for six years with positive rheumatoid factor and anticardiolipin under rheumatoid arthritis treatment for five years. Examination revealed diffuse cutaneous infiltration and leonine facies, characteristic features of lepromatous leprosy. Autoantibodies such as rheumatoid factor and anticardiolipin are markers of rheumatic autoimmune diseases, but their presence is also described in leprosy. We report the present case in order to alert health professionals to remember leprosy, even in areas where the disease is considered eliminated as a public health problem, avoiding misinterpretations of serologic findings and misdiagnosis.

Lepromatous leprosy or rheumatoid arthritis with leprosy? A challenging case

“…The study highlighted the need of considering the possibility of leprosy, even in areas where the is disease is considered as eradicated. 13 Non-leprotic manifestations are common in leprosy. The study by Haroon et al have noted the presence of pure neuritic leprosy in 5 patients having inflammatory arthritis with/without tenosynovitis and tenosynovitis.…”

Erythema nodosum leprosum as presenting feature of lepromatous leprosy

“…Because of the aforementioned resemblance to rheumatologic conditions, lepromatous leprosy presenting with polyarthritis, muscle weakness and diffuse maculopapular rash can be very challenging for physicians to diagnose, especially in a developed nation with low incidence. We report a case of lepromatous leprosy presenting with painful maculopapular rash and polyarthritis [1,2]. www.casereportsinternational.com…”

“…It is known to be a great mimicker of rheumatologic disease and can present with a wide variety of clinical signs and symptoms resembling rheumatoid arthritis (RA), seronegative spondyloarthropathies (SA), lupus, or even systemic necrotizing vasculitis. The lack of knowledge about this condition in countries where the disease is considered eradicated, contributes to late diagnosis [1,2].…”

New insights at the interface between leprosy and immune-mediated rheumatic diseases

“…These include living in areas with a high burden of the disease, having close contact with an infected individual, and having a weakened immune system due to other health conditions such as HIV/AIDS and medication-induced immunosuppression. Poverty, poor nutrition, and inadequate healthcare also increase the risk of developing leprosy ( 3 , 4 ).…”