Leprosy initially misdiagnosed as sarcoidosis, adult-onset still disease, or autoinflammatory disease

Sara Simeoni, Antonio Puccetti, Elisa Tinazzi, Orazio Michele Codella, Michele Sorleto, Giuseppe Patuzzo, Chiara Colato, Gianpaolo Tessari, Claudio Lunardi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

ABSTRACT: Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae. We describe the case of a 20-year-old man from India living in Italy since 2003, who presented with erythematous papules and nodules distributed on his arms, legs, and face in 2006. He also had episodes of high fever, polyarthritis, and episcleritis. Sarcoidosis was suspected on the basis of elevated angiotensin-converting enzyme and bronchoalveolar lavage fluid, and the patient was treated with corticosteroids for about a year. A flare of the disease occurred each time corticosteroid was tapered or suspended. An autoinflammatory disease was then suspected and treated with immunosuppressant. Only the third deep skin biopsy revealed the presence of M. leprae. The lack of clinical suspicion and the unfamiliarity with the histology of leprosy delayed diagnosis and treatment. Leprosy should be considered in the differential diagnoses of patients presenting with rheumatic and cutaneous manifestations especially when they come from countries where the disease is endemic.

Original languageEnglish
Pages (from-to)432-435
Number of pages4
JournalJournal of Clinical Rheumatology
Volume17
Issue number8
DOIs
Publication statusPublished - Dec 2011

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Adult-Onset Still's Disease
Leprosy
Sarcoidosis
Diagnostic Errors
Mycobacterium leprae
Adrenal Cortex Hormones
Scleritis
Skin Manifestations
Chronic Granulomatous Disease
Endemic Diseases
Delayed Diagnosis
Bronchoalveolar Lavage Fluid
Peptidyl-Dipeptidase A
Immunosuppressive Agents
Italy
Arthritis
India
Leg
Histology
Arm

Keywords

  • leprosy
  • sarcoidosis
  • Still disease

ASJC Scopus subject areas

  • Rheumatology

Cite this

Leprosy initially misdiagnosed as sarcoidosis, adult-onset still disease, or autoinflammatory disease. / Simeoni, Sara; Puccetti, Antonio; Tinazzi, Elisa; Codella, Orazio Michele; Sorleto, Michele; Patuzzo, Giuseppe; Colato, Chiara; Tessari, Gianpaolo; Lunardi, Claudio.

In: Journal of Clinical Rheumatology, Vol. 17, No. 8, 12.2011, p. 432-435.

Research output: Contribution to journalArticle

Simeoni, S, Puccetti, A, Tinazzi, E, Codella, OM, Sorleto, M, Patuzzo, G, Colato, C, Tessari, G & Lunardi, C 2011, 'Leprosy initially misdiagnosed as sarcoidosis, adult-onset still disease, or autoinflammatory disease', Journal of Clinical Rheumatology, vol. 17, no. 8, pp. 432-435. https://doi.org/10.1097/RHU.0b013e31823a55e5
Simeoni, Sara ; Puccetti, Antonio ; Tinazzi, Elisa ; Codella, Orazio Michele ; Sorleto, Michele ; Patuzzo, Giuseppe ; Colato, Chiara ; Tessari, Gianpaolo ; Lunardi, Claudio. / Leprosy initially misdiagnosed as sarcoidosis, adult-onset still disease, or autoinflammatory disease. In: Journal of Clinical Rheumatology. 2011 ; Vol. 17, No. 8. pp. 432-435.
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