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 journalArticlepeer-review

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

Keywords

  • leprosy
  • sarcoidosis
  • Still disease

ASJC Scopus subject areas

  • Rheumatology

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