Lest we forget Hansen's disease (leprosy): an unusual presentation with an acute onset of inflammatory polyarthritis and the rheumatology experience.
Several forms of arthritis and rheumatism can sometimes complicate leprosy. However, its presentation as an acute onset arthritis is unusual. We report two adult male naïve patients who presented to our rheumatology outpatient clinic with acute onset inflammatory polyarthritis, skin rash and mild sensory neurodeficit. Borderline lepromatous leprosy (in type I lepra reaction) was diagnosed. We also refer to 19 case records of Hansen arthritis in the clinic database (1998-2007) from approximately 35,000 patients and a community study to highlight the missed diagnosis of Hansen's disease and its unusual association with rheumatoid arthritis. In countries like India where leprosy is endemic, this disease also merits attention in rheumatology clinics.
Sheetal
Salvi
S
Center for Rheumatic Disease, Pune, India.
Arvind
Chopra
C
D000208:Acute Disease; D000368:Aged; D001168:Arthritis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology; D002991:Clofazimine / Q000627:therapeutic use; D003622:Dapsone / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D005076:Exanthema / Q000382:microbiology / Q000473:pathology; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D007918:Leprosy / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000302:isolation & purification; D010525:Peripheral Nerves / Q000473:pathology; D010523:Peripheral Nervous System Diseases / Q000382:microbiology / Q000473:pathology; D012293:Rifampin / Q000627:therapeutic use; D016896:Treatment Outcome
D005938:Glucocorticoids; D007917:Leprostatic Agents; D003622:Dapsone; D002991:Clofazimine; D012293:Rifampin