RESUMO
An inflammatory polyarthritis has been previously described in leprosy but accounts of the clinical characteristics have varied. All patients with joint symptoms admitted to a leprosy centre over 5 months were examined by a rheumatologist. Of 48 acute admissions, 20 (42%) had a symmetrical polyarthritis affecting the wrists and fingers. This was strikingly similar to RA in appearance. The arthritis occurred exclusively in patients with reactions mainly during anti-mycobacterial treatment. The clinical features of the joint disorder were identical in Type I (associated with alterations in immune status) and Type II (erythema nodosum leprosum) reactions. Synovial tissue from one patient revealed no mycobacteria. Four of five hand X-rays suggested small erosions of the finger joints.
Assuntos
Artrite Infecciosa/complicações , Hanseníase/complicações , Doença Aguda , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Artrite Infecciosa/diagnóstico por imagem , Artrite Infecciosa/etiologia , Feminino , Humanos , Hanseníase/classificação , Hanseníase/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Mycobacterium leprae , RadiografiaAssuntos
Artrite Infecciosa/etiologia , Hanseníase/complicações , Adulto , Anticorpos Antinucleares/sangue , Artrite Infecciosa/sangue , Artrite Infecciosa/diagnóstico por imagem , Proteínas Sanguíneas/análise , Sedimentação Sanguínea , Proteína C-Reativa/análise , Feminino , Humanos , Lúpus Eritematoso Sistêmico/patologia , Masculino , Osteoporose/diagnóstico por imagem , Radiografia , Fator Reumatoide/sangue , Soroglobulinas/análiseRESUMO
Arthritis associated with leprosy is underreported. In Egypt 66 patients from a leprosy colony were studied, 20 of whom had arthropathy. This was characterised by an inflammatory symmetrical peripheral polyarthritis. The wrist, metacarpal and proximal interphalangeal joints of the hands, the knees, and the metatarsophalangeal joints of the feet were affected with associated morning stiffness. The arthritis was erosive in 11 out of 20 patients, had no features of the arthritis associated with erythema nodosum leprosum reactions, but symptomatically responded to antileprosy treatment. This arthritis would seem to be a previously unrecognised feature of leprosy.