RESUMO
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.
Assuntos
Artrite Reumatoide/diagnóstico , Hanseníase Virchowiana/diagnóstico , Diagnóstico Diferencial , Humanos , Hanseníase Virchowiana/tratamento farmacológico , Hanseníase Virchowiana/patologia , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/tratamento farmacológico , Doenças Negligenciadas/patologiaRESUMO
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.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Artrite Reumatoide/diagnóstico , Hanseníase Virchowiana/diagnóstico , Hanseníase Virchowiana/patologia , Hanseníase Virchowiana/tratamento farmacológico , Diagnóstico Diferencial , Doenças Negligenciadas/diagnóstico , Doenças Negligenciadas/patologia , Doenças Negligenciadas/tratamento farmacológicoRESUMO
Em 1963, Wade descreveu a hanseníase histoide, que acometia pacientes previamente tratados com dapsona.Caracteriza-se por lesão com aspecto queloideano, na histopatologia vemos histiócitos fusiformes e um grande número de bacilos. Relata-se caso de hanseníase dimorfa virchoviana com padrão de lesão históide, um verdadeiro desafio diagnóstico, a fim de atentar para manifestações atípicas dessa doença e reforçar a importância da confirmação histológica de casos suspeitos de hanseníase históide.
In 1963, Wade described Histoid Leprosy, that affected patients previously treated with dapsone. This type of leprosy is characterized by keloid-like lesions, in which spindle histiocytes and a large number of bacilli can be seen in the histopathology. A case of borderline lepromatous leprosy with histoid pattern is described, a true diagnostic challenge, in order to attempt to atypical manifestations of the disease and reinforce the importance of histological confirmation in suspected cases of histoid leprosy.