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Leprosy Can Present With Rheumatological Symptoms

First five known cases of leprosy with articular involvement and without skin lesions described

FRIDAY, April 13 (HealthDay News) -- Physicians in India describe the first five known cases of leprosy presenting with primarily rheumatological symptoms without accompanying cutaneous features, according to a report published in the April issue of Rheumatology.

Vikas Agarwal, M.D., of the Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow, India, and colleagues screened medical records of nearly 12,000 patients from their center, looking for patients diagnosed with leprosy.

Twenty of 28 leprosy cases presented primarily with rheumatological symptoms. Five of these had pure neuritic leprosy with rheumatic features. Four of the five had symmetric polyarthritis with or without tenosynovitis, and one only tenosynovitis. Rheumatoid factor tests were negative, while all five patients exhibited abnormal nerve conduction studies, neuropathy, thickened nerves and Mycobacterium leprae in nerve biopsies.

"A combination of tenosynovitis and thickened nerves in association with/without symmetric polyarthritis should raise a suspicion of leprosy even in the absence of cutaneous features," the authors write.

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