Lepromatous Leprosy Mimicking Systemic Lupus Erythematosus

Abstract

A 29-year-old Brazilian woman was referred for management of systemic lupus erythematosus (SLE) with antiphospholipid antibodies (aPL). Her symptoms were 1 year of intermittent fever and diffuse, tender, erythematosus, and nodular rash that began during her first pregnancy. She was treated with short course of lowdose corticosteroids, with resolution; however, she suffered an embryonic loss at 7 weeks. Six months prior to admission, she had recurrence of the nodular rash with new onset arthralgia; a skin biopsy showed panniculitis.

Bacterial infections in lupus: Roles in promoting immune activation and in pathogenesis of the disease

“…Lupus-prone MRL/lpr mice have also been shown to be susceptible to infection with M. leprae , while non-obese diabetic (NOD) mice were resistant [ 113 ]. Infection by either Mycobacterium tuberculosis or Mycobacterium leprae in humans can mimic autoimmune diseases like lupus and can result in significantly increased titers of autoantibodies [ [159] , [160] , [161] ]. Due to this phenotype, mycobacterial infection in SLE patients is often mistaken for a lupus flare, resulting in delay in treatment and uncontrolled infection.…”

Lepromatous leprosy mimicking systemic lupus erithematosus: a case report

“…1,8 The clinical presentations of leprosy vary and may include erythema nodosum, arthritis, fever, skin erythema, vasculitis, epididymitis, glomerulonephritis, pericarditis, and pleuritis. 9 The patient in this case showed generalized erythematous and hyperpigmented ill-defined patches all over his face, trunk, and forelimbs. Physical, sensory, and motor examination results were compatible with the clinical finding of leprosy.…”

“…Joint complications resembling rheumatoid arthritis may occur in leprosy. 9 Osteoarticular manifestations are the third most common complication after skin and peripheral nerve system involvement. 1,9 Diagnosis can be established through full-depth skin or nerve biopsy smears.…”

“…9 Osteoarticular manifestations are the third most common complication after skin and peripheral nerve system involvement. 1,9 Diagnosis can be established through full-depth skin or nerve biopsy smears. 9 Patients with the LL classification have very high bacillary loads and appear with many diffuse skin lesions without loss of nerve sensation.…”

“…1,9 Diagnosis can be established through full-depth skin or nerve biopsy smears. 9 Patients with the LL classification have very high bacillary loads and appear with many diffuse skin lesions without loss of nerve sensation. 6 The patient's slit-skin smear and histological findings were compatible with HD.…”