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© 1994 British Society for Rheumatology

review-article

ARTHRITIS OF LEPROSY

T. GIBSON, Q. AHSAN and K. HUSSEIN

Department of Medicine, Aga Khan University Hospital and Marie Adelaide Leprosy Centre Karachi, Pakistan

Correspondence to: Correspondence to: T. Gibson, Guy's Hospital, London SE1 9RT.

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.

KEY WORDS: Mycobacterium leprae, Symmetrical polyarthritis, Leprosy reactions


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