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Abstract

Leprosy patients could display a great variability of signs and symptoms. An overabundance of rheumatic manifestations, occuring alone or in varying combinations, are associated with leprosy, particularly with lepra reactions A study involving seventy cases of leprosy found that rheumatic manifestations were seen in 61.42% of cases: arthritis in 54.28% and soft tissue rheumatism in 17.14%. Enthesitis was seen in 2.84% of cases. Rheumatic manifestations may be the primary complaint, thus delaying accurate diagnosis. Musculoskeletal involvement in leprosy is the third most frequent manifestation after dermatological and neurological involvements. It can occur at anytime during the infection. Articular inflammation in leprosy, which closely mimics other rheumatic disorders, usually occurs in reactive states, particularly erythema nodosum leprosum (ENL).1 About 1–5% of leprosy patients are reported of developing arthritis (synovial inflammation) at some stage of the disease but this rate increases to over 50% during lepra reactions.2 Here we report a case of arthritis in leprosy
without any typical skin lesion thus causing a delay in diagnosis.

Article Details

How to Cite
Dewi, S., & Setiyohadi, B. (2018). Arthritis in leprosy without specific skin lesion. Indonesian Journal of Rheumatology, 2(1). https://doi.org/10.37275/ijr.v2i2.34

References

  1. Vengadakrishnan K, Saraswat PK, Mathur PC. A study of rheumatological manifestations of leprosy. Indian J Dermatol Venereol Leprol 2004;70:76-8.
  2. Ribeiro SLE, Pereira HLA, Silva NP, Neves RMS, Sato EI. Anti-cyclic citrullinated peptide antibodies and rheumatoid factor in leprosy patients with articular involvement. Braz J Med Biol Res 2008;41:1005–10.
  3. Haroon N, Agarwal V, Agarwal A, Kumari N, Krishnani N, Mishra R. Arthritis as presenting manifestation of pure neuritic leprosy—a rheumatologist dilemma. Rheumatol 2007;46:653–6.
  4. Gill AL, Bell DR, Gill GV, Wyatt GB, Beeching NJ. Leprosy in Britain: 50 years experience in Liverpool. Q J Med 2005;98:505–11.
  5. Health Agency of East Java Province. The Nippon Foundation’s visitation for leprosy in Indonesia and East Java [Kunjungan The Nippon Foundation seputar kusta di Indonesia dan Jawa Timur]. [Online]. 2009 Jun 13 [cited 2010 Jul 20]; Available from: URL:http://www. surabaya-ehealth.org/dkksurabaya/berita/kunjungan-nippon-foundationseputar-kusta-di-indonesia-dan-jawa-timur.
  6. Britton WJ, Lockwood DN. Leprosy. Lancet 2004;363:1209–19.
  7. Pernambuco JC, Cossermelli-Messina W. Rheumatic manifestations of leprosy: clinical aspects. J Rheumatol 1993;20:897–9.
  8. Armour KS, Scolyer RA, Barnetson RS. Borderline lepromatous leprosy presenting as a single cutaneous plaque. Australas J Dermatol2005,46(3):181–3.
  9. Jha PK, Talwar S, Suresh MS, Panvelkar V. Localized borderline lepromatous leprosy. Lepr Rev 1991;62(2):212–6.
  10. Sapkota BR, Neupane KD, Maharjan RK. Single lesion multibacillary leprosy, a treatment enigma: a case report. J Med Case Reports 2009;3:8.
  11. Cossermelli-Messina W, Festa-Neto C, Cossermelli W. Articular infl ammatory manifestations in patients with different forms of leprosy. J Rheumatol 1998; 25:111–9.
  12. Al-Raqum HA, Uppal SS, El Abdalghani RA, Lasheen I. First report of leprosy presenting as acute polyarthritis in the setting of type I downgrading lepra reaction. Clin Rheumatol 2006;25(1):101–5.
  13. Holla VV, Kenetkar MV, Kolhatkar MK, Kulkarin CN. Leprous synovitis. A study of fi fty cases. Int J Lepr Other Mycobact Dis 1983;51(1):29–32.
  14. Moonot P, Ashwood N, Lockwood D. Orthopaedic complications of leprosy. J Bone Joint Surg Br 2005;87B:1328–32.

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