02123nas a2200397   4500000000100000008004100001260001600042653001000058653001400068653001100082653001800093653001800111653002300129653001100152653002800163653002100191653002100212653001100233653001200244653000900256653001200265653002500277653001300302653000900315653001100324100001500335700001800350700001600368700001500384245010400399856008200503300001100585490000600596520110900602022001401711       1975                            d  c1975 Sep 1310aAdult10aArthritis10aBiopsy10aComplement C310aCryoglobulins10aGlomerulonephritis10aHumans10aImmune Complex Diseases10aImmunoglobulin G10aImmunoglobulin M10aKidney10aleprosy10aMale10aMuscles10aMycobacterium leprae10aMyositis10aSkin10aUremia1 aIveson J M1 aMcDougall A C1 aLeathem A J1 aHarris H J00aLepromatous leprosy presenting with polyarthritis, myositis, and immune-complex glomerulonephritis.  uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC1674437/pdf/brmedj01464-0021.pdf  a619-210 v33 a<p>A Pakistani man aged 19 years was admitted to a rheumatological unit in the United Kingdom with acute widespread polyarthritis accompanied by night sweats and fever. Preliminary examination suggested Reiter's disease, but further investigation showed acute glomerulonephritis with uraemia. The possibility of periarteritis nodosa, and the prominence of muscle tenderness in the legs, led to biopsies of striated muscle and skin, in both of which were changes typical of lepromatous leprosy, with many Mycobacterium leprae on Ziehl-Neelsen staining. Serum showed IgG-IgM cryoglobulinaemia without antiglobulin activity, and in the recovery phase renal biopsy showed a resolving proliferative glomerulonephritis with linear IgG and IgM immunofluorescence and granular deposits of C3. Clinical signs subsided rapidly under steroid treatment and subsequent progress on anti-leprosy drugs was uneventful. The term erythema nodosum leprosum is inadequate and misleading as a title for a common and important immune-complex reaction of lepromatous leprosy, in which numerous body systems may be involved.</p>  a0007-1447