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Arthritis of leprosy
1Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
British Journal of Rheumatology
|October 1, 1994
Summary
Leprosy patients often develop symmetrical polyarthritis, resembling rheumatoid arthritis, particularly during treatment reactions. This joint inflammation, seen in both Type I and Type II leprosy reactions, can cause finger joint erosions.
Area of Science:
- Rheumatology
- Infectious Diseases
- Immunology
Background:
- Inflammatory polyarthritis in leprosy is known but clinical details vary.
- Leprosy reactions, particularly during anti-mycobacterial treatment, are associated with joint symptoms.
Purpose of the Study:
- To describe the clinical characteristics of polyarthritis in leprosy patients.
- To compare the joint disorder in different types of leprosy reactions.
Main Methods:
- Rheumatological examination of leprosy patients with joint symptoms.
- Analysis of clinical features during acute admissions.
- Hand X-rays and synovial tissue analysis in select cases.
Main Results:
- 42% of acute leprosy admissions presented with symmetrical polyarthritis affecting wrists and fingers.
- The arthritis occurred exclusively during leprosy reactions, mainly during treatment.
- Clinical features were identical in Type I and Type II (erythema nodosum leprosum) reactions.
- Synovial tissue did not reveal Mycobacterium.
- Hand X-rays suggested small finger joint erosions in 4 out of 5 patients.
Conclusions:
- Leprosy-associated polyarthritis closely mimics rheumatoid arthritis.
- The joint disorder is linked to leprosy reactional states, irrespective of type.
- Erosive changes may occur in leprosy-associated arthritis.