Case of arthritis secondary to leprosy.

Introduction

Leprosy is a chronic granulomatous infectious disease, which is caused byMycobacterium leprae. High numbers of people are still affected by this disease in some of the developingcountries however, it is rarely seen in non-endemic regions.Cutaneous and neurological manifestations are the common and classical presentations of leprosy. Musculoskeletal involvement is the third most common manifestation but is lessfrequently reported.Joint involvement can present as acute symmetrical polyarthritisor chronic polyarthritisresembling rheumatoid arthritis. Leprosy can also present with tenosynovitis, either isolated or associated with arthritis.

Case presentation

We report a case of 29-year-old man who developed tenosynovitis and acutesymmetricalpolyarthritis including small joints of hands and feet three weeksafter appearance of typical cutaneous lesion of leprosy. Patient improved with steroid and antileprosy treatment. Patienthad another acute episode with symmetrical polyarthritis four monthslater while on treatment.

Discussion and evaluation

In the modern era, there is increase movement of population from developing countries to developed countries, it is likely that patient suffering from leprosy with arthritis may present to rheumatology clinic in those countries where leprosy is not endemic. Exact pathogenesisfor musculoskeletal manifestations is still not fully known. Our patient presented withsymmetrical polyarthritis, enthesitis and systemic involvement, which was secondary to leprareaction.