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BMJ Case Reports 2012; doi:10.1136/bcr.12.2011.5346
  • Unusual association of diseases/symptoms

Leprosy and rheumatoid arthritis: consequence or association?

  1. Nuno Riso1
  1. 1Internal Medicine Department 2, Curry Cabral Hospital, Lisbon, Portugal
  2. 2Dermatology Department, Hospital Curry Cabral, Lisbon, Portugal
  3. 3Internal Medicine 4 Department, Fernando da Fonseca Hospital, Amadora, Portugal
  1. Correspondence to Dr Celia Coelho Henriques, celia.c.henriques{at}gmail.com

Summary

Leprosy or Hansen’s disease is a chronic granulomatous infectious disease caused by Mycobacterium leprae with a high prevalence in some developing countries however, it is rarely seen in non-endemic regions. Arthritis has been described in all types of Hansen’s disease. Chronic arthritis is known to exist even in paucibacillary forms, resolved or treated disease and in patients without reaction, suggesting a perpetuated inflammatory process. In these cases leprosy can mimic some autoimmune diseases such as rheumatoid arthritis. When a patient with a history of leprosy presents with a symmetric, distal, polyarthritis the diagnosis may not be linear. Possibly it is a rheumatoid-like leprous arthritis with M leprae acting as the trigger element for the chronic process or it is an overlap condition, with a concomitant rheumatoid arthritis? A case report of a patient with a chronic inflammatory arthritis with 10 years of evolution is presented. The differential diagnosis between leprous and rheumatoid arthritis is discussed.

Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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