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Leprosy in a rheumatology setting: a challenging mimic to expose

Authors
  • Salvi, Sheetal1
  • Chopra, Arvind2
  • 1 Bharati Vidyapeeth Medical College, Department of Physiology, NIBM Road, 10 Memory Garden, Kondhwa, Pune, 411048, India , Pune (India)
  • 2 Center for Rheumatic Diseases, Hermes Elegance, Convent St, Camp, Pune, 411001, India , Pune (India)
Type
Published Article
Journal
Clinical Rheumatology
Publisher
Springer-Verlag
Publication Date
May 07, 2013
Volume
32
Issue
10
Pages
1557–1563
Identifiers
DOI: 10.1007/s10067-013-2276-5
Source
Springer Nature
Keywords
License
Green

Abstract

Leprosy can manifest arthritis both as a complication and a comorbid disorder and can be a challenging differential diagnosis in rheumatology practice due to several common features. Uncommonly, it may present as acute severe polyarthritis with skin lesions and neurological deficit or a digital vasculitis and gangrene. We demonstrate this profile in a retrospective case series analysis of 33 patients (13 females, median age 55 years) in a community-based clinic setting over the period 1998–2012; an electronic search of case records of 41,000 patients was carried out. Rheumatoid arthritis (RA) coexisted in seven patients (three lepromatous, two tuberculoid, and two polyneuritic). Serological rheumatoid factor and antinuclear antibody were often false positive. Several patients of RA were on long-term supervised methotrexate. Rheumatologists should be aware of this clinical mimic to avoid errors in diagnosis and management.

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