Rheumatoid arthritis-like features in Hansen disease: A case report

Hansen's Disease, the Perpetual Impersonator ("The Behroopiya") of Rheumatology Practice: A Case Series

We encountered five patients with Rheumatic symptoms, suspected to have five different clinical diagnoses: Systemic vasculitis, Gout, Systemic Sclerosis, Rheumatoid Arthritis, and Spondyloarthropathy. However, all were finally diagnosed with the same illness: Hansen's Disease.

Neglected tropical rheumatic diseases

The complexities of dealing with rheumatic diseases in tropical countries are diverse and likely due to limited health care infrastructure, lack of diagnostic and therapeutic facilities, impact of dominant prevailing diseases, and the challenges of differentiating from infectious and non-infectious disease mimics. Several tropical diseases present with musculoskeletal and rheumatic manifestations and often pose a diagnostic dilemma to rheumatologists. The diagnosis is often delayed or the disease is misdiagnosed, leading to poor patient outcomes. Endemic tropical diseases like tuberculosis and leprosy have myriad rheumatic presentations and remain important differentials to consider in patients with rheumatic manifestations. Infection with human immunodeficiency virus is a great masquerade and can mimic manifestations of multiple diseases. The role of viral infections in triggering and perpetuating autoimmunity is well known and chikungunya arthritis is a classic example of the same. This review highlights the rheumatic manifestations of tropical diseases and aims to create awareness among the caregivers. Key Points • It is crucial to be aware and identify infectious diseases presenting with rheumatic manifestations in the tropics. • Presentations akin to classic rheumatic syndromes such as rheumatoid arthritis, spondyloarthritis, systemic lupus erythematosus and vasculitis are common.

Leprosy Mimicking as Rheumatoid Arthritis: A Case Report

Leprosy is a chronic granulomatous infection caused by Mycobacterium leprae, which mainly damages the skin and peripheral nerves, and can also infect joints and bones. Clinical manifestations are complex, varied, and often underdiagnosed. The clinical manifestations vary and are called "the great imitator". musculoskeletal features are common in leprosy but infrequently reported. A case of borderline lepromatous (BL) type leprosy was initially suspected as rheumatoid arthritis in a 20-year-old Balinese male who complained of pain and swelling in small joints, accompanied by lesions in the form of multiple erythema macules, round-shaped geography, indistinct boundaries, with bilateral distribution is almost symmetrical in the face, thoracoabdominal, and extremity regions. The diagnosis of BL type leprosy is based on history taking, physical examination, and investigations in the form of Ziehl-Neelsen stain and blood tests.

Leprosy-Related Chronic Arthritis with an Abundance of Mycobacterium Leprae in the Synovial Fluid: A Rare Case

Bone and joint involvements are the most common manifestation in leprosy, after cutaneous and neurological manifestations, yet are underdiagnosed and rarely reported. We report a case of lepromatous leprosy in a 41-year-old male with bone and joint changes. Physical examination revealed a leonine face, madarosis, hypesthetic hypopigmented macules on the back, and swelling of fingers and toes. Acid-fast bacilli from slit-skin smear and synovial fluid in an interphalangeal joint of the hand were found. Radiographic features showed osteolysis and destruction of some phalanges of the hands, bone erosion and destruction of some phalanges of the feet, as well as destruction and subluxation of some hand joints. The patient was given multidrug therapy for multibacillary leprosy, resulting in the reduction of swelling in fingers and toes. In conclusion, the examination of bone and joint changes in leprosy patients is important for early detection and management of musculoskeletal complications, to prevent future deformities and disabilities.