[Articular manifestations in acromegaly: diagnostic and therapeutic implications of the coexistence of acromegalic arthropathy and rheumatoid arthritis].

The presence of arthropathy in patients with acromegaly may suggest recurrence of acromegaly or the existence of an inflammatory joint disease such as rheumatoid arthritis (RA). Few publications have evaluated the coexistence of RA and acromegaly. Two cases were presented with a coexistence of RA and acromegalic arthopathy, which enabled us to evaluate the key factors in differential diagnoses and the implications for treatment. Diagnosis of RA in patients with acromegaly requires a high level of clinical suspicion, and should therefore be considered in cases where adequate symptom control is not achieved. Delay in the diagnosis and treatment of RA can increase joint damage and possibly worsen a patient's functional prognosis.

Manifestaciones articulares en la acromegalia: implicaciones diagnósticas y terapéuticas de la coexistencia de la artropatía acromegálica y artritis reumatoide / Articular manifestations in acromegaly: diagnostic and therapeutic implications of the coexistence of acromegalic arthropathy and rheumatoid arthritis

La presencia de artropatía en los pacientes con acromegalia puede ser debida a la recurrencia de la acromegalia o a la existencia de una enfermedad articular inflamatoria como la artritis reumatoide (AR). Existen pocas publicaciones que evalúen la coexistencia de AR y acromegalia. La presentación de dos casos con la coexistencia de AR y artropatía acromegálica permite evaluar las claves para su diagnóstico diferencial y sus implicaciones en el tratamiento. El diagnóstico de AR en los pacientes con acromegalia requiere de una alta sospecha clínica, por lo que debería ser considerado en aquellos casos en los que no se consiga un adecuado control de los síntomas. El retraso en el diagnóstico y tratamiento de la AR puede incrementar el daño articular y posiblemente empeora el pronóstico funcional de los pacientes

The presence of arthropathy in patients with acromegaly may suggest recurrence of acromegaly or the existence of an inflammatory joint disease such as rheumatoid arthritis (RA). Few publications have evaluated the coexistence of RA and acromegaly. Two cases were presented with a coexistence of RA and acromegalic arthopathy, which enabled us to evaluate the key factors in differential diagnoses and the implications for treatment. Diagnosis of RA in patients with acromegaly requires a high level of clinical suspicion, and should therefore be considered in cases where adequate symptom control is not achieved. Delay in the diagnosis and treatment of RA can increase joint damage and possibly worsen a patient's functional prognosis

Multibacillary leprosy mimicking systemic lupus erythematosus: case report and literature review.

Leprosy is an infectious chronic disease with a wide range of clinical and serological manifestations. We report a case of a woman presenting with a malar rash, painless oral ulcers, photosensitivity, arthritis, positive antinuclear antibodies test and leuko-lymphopenia. Our case illustrates an unusual presentation of leprosy initially diagnosed as systemic lupus erythematosus (SLE). After the confirmation of multibacillary leprosy and multidrug therapy recommended by the World Health Organization, a good clinical response was observed. Recognition of rheumatic manifestations in leprosy is important as they may be confused with SLE. A literature review is presented to encourage clinicians to consider leprosy as a differential diagnosis. Specifically in patients with unusual rheumatic manifestations and persistent skin lesions, and when neurological symptoms are present. Leprosy has not been eradicated, so misdiagnosis can be frequent. It is necessary to increase medical practitioner awareness in order start proper treatment.