Mal de Hansen, anticorpos antifosfolípides e obstrução das artérias fibulares

Wallin, Liz; Beckhauser, Ana Paula; Haider, Osvaldo; Araújo, Francisco Alves de; Silva, Marilia Barreto; Skare, Thelma L.

doi:10.1590/s0482-50042009000200009

Cited by 5 publications

(3 citation statements)

References 15 publications

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“…Nerve dysfunction, developing months or years after MDT, may occur independently of overt reactions or relapse, leading to chronic progressive polyneuropathy or multiple mononeuropathies in the absence of active leprosy 19 . It is noteworthy that leprosy relapses can present similarly to vasculitis and other autoimmune connective tissue diseases, potentially complicating the differential diagnosis 20 . In the case presented, the initial diagnosis wavered between vasculitis and leprosy relapse.…”

Section: Discussionmentioning

confidence: 90%

“… 19 It is noteworthy that leprosy relapses can present similarly to vasculitis and other autoimmune connective tissue diseases, potentially complicating the differential diagnosis. 20 In the case presented, the initial diagnosis wavered between vasculitis and leprosy relapse. However, subsequent laboratory investigations enabled us to conclusively eliminate vasculitis, thereby affirming the diagnosis of leprosy relapse.…”

Section: Discussionmentioning

confidence: 93%

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Challenging in leprosy relapse with antiphospholipid syndrome diagnosis: A case report

Kolahi,

Ghadakchi,

Jabbaripour Sarmadian

et al. 2024

Clinical Case Reports

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Key Clinical MessageInfectious diseases like leprosy can cause antiphospholipid antibodies, leading to blood clots. Clinicians should consider this for patients with unusual thrombotic events and prior infectious disease history.AbstractThis case report details the diagnostic challenge of a 42‐year‐old man with a history of treated leprosy who presented with clinical features suggestive of antiphospholipid syndrome (APS). Vascular angiography revealed thrombosis, and serological tests were positive for APS antibodies. However, the patient subsequently developed symptoms, including thenar atrophy, paresthesia, and hypopigmented skin patches, which prompted further investigation. Electromyography detected sensorimotor polyneuropathy, while a nerve biopsy indicated a resurgence or chronic presence of leprosy. Despite initial APS management, the case evolved into a leprosy relapse confirmation after 20 years of remission, underscoring the diagnostic intricacies when concurrent autoimmune antibodies and infectious disease manifestations are present. This report emphasizes the importance of considering a broad differential diagnosis, including the potential for infectious disease relapse, in the presence of antiphospholipid antibodies. It illustrates the necessity of an interdisciplinary treatment approach in complex clinical scenarios.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 93%

Challenging in leprosy relapse with antiphospholipid syndrome diagnosis: A case report

Kolahi,

Ghadakchi,

Jabbaripour Sarmadian

et al. 2024

Clinical Case Reports

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“…The presence of ANCA was studied in 68 patients with leprosy, finding ANCA-p in 31% of those with the lepromatous form and 16% of those with the borderline form; ANCA-c was seen in 5% of those with the lepromatous form. 6 Other less frequent manifestations are Raynaud's phenomenon, livedo reticularis, skin thickening and periorbital edema5. Therefore, it is important to expand the range of differential diagnoses of diseases that can affect blood vessels, as shown in Table 1.…”

Section: Introductionmentioning

confidence: 99%

Leprosy mimicking ANCA-associated vasculitis

Daameche¹,

Lins²,

Pires³

et al. 2023

IJFCM

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Vasculitis represents a large group of diseases, classified between primary and secondary. Diagnosis of primary vasculitis is a challenge in medical practice, since there are wide and heterogeneous clinical manifestations, with diagnostic criteria still scarce. Some clinical manifestations are common: constitutional status, myalgia, arthralgia, arthritis, papules, nodules and ulcers. One of the clinical forms is the limited one in which patients with upper respiratory tract involvement often evolve with systemic disease. Most patients have nasal, sinus or ear involvement that may be present weeks or months before other symptoms. Secondary vasculitis can be related to infections, drugs, toxic substances and neoplasms. The virchowian and dimorphic form of leprosy has similar clinical and serological characteristics with rheumatological diseases. As it is an endemic disease in Brazil, there is a description of a wide variety of clinical presentations, so making a differential diagnosis is essential.

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Trombosis venosa profunda en paciente con lepra lepromatosa tratado con talidomida por leprorreacción

Petiti-Martin

Villar-Buill

Hera

et al. 2013

Actas Dermo-Sifiliográficas

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Thalidomide is the treatment of choice for severe or recurrent erythema nodosum leprosum. Its use has been associated with deep vein thrombosis in patients with blood disorders, however, particularly when used in combination with corticosteroids or chemotherapy. We describe a case of deep vein thrombosis in a 43-year-old man with lepromatous leprosy who was being treated with thalidomide and prednisone for a type 2 leprosy reaction (erythema nodosum leprosum); the patient also had transiently positive antiphospholipid antibody results. We stress the importance of considering deep vein thrombosis, a potentially fatal complication, in dermatology patients treated with thalidomide.

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Mal de Hansen, anticorpos antifosfolípides e obstrução das artérias fibulares

Abstract: ABSTRACT

Cited by 5 publications

References 15 publications

Challenging in leprosy relapse with antiphospholipid syndrome diagnosis: A case report

Challenging in leprosy relapse with antiphospholipid syndrome diagnosis: A case report

Leprosy mimicking ANCA-associated vasculitis

Trombosis venosa profunda en paciente con lepra lepromatosa tratado con talidomida por leprorreacción

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