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Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report
BACKGROUND: Leprosy typically manifests with skin and peripheral nerve involvement. Musculoskeletal complaints are the third most common, and can be the sole presenting manifestation. They range from arthralgia/arthritis in reactional states to full mimics of systemic rheumatic diseases. Remitting S...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530132/ https://www.ncbi.nlm.nih.gov/pubmed/31117984 http://dx.doi.org/10.1186/s12879-019-4098-9 |
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author | Guerra, Miguel Gomes Videira, Taciana Marta Ferreira Cardoso Morais, Hugo Alexandre Gomes Santos, Telma Cristiana Resse Nunes Taipa, Ricardo Jorge Ferreira Abreu, Miguel Araújo Vieira, Romana Carisa Carvalho da Fonseca, Diogo Miranda Gonçalves Guimarães dos Santos, Joana Patrícia Abelha Aleixo Pinto, Sandra Patrícia Abreu Monteiro |
author_facet | Guerra, Miguel Gomes Videira, Taciana Marta Ferreira Cardoso Morais, Hugo Alexandre Gomes Santos, Telma Cristiana Resse Nunes Taipa, Ricardo Jorge Ferreira Abreu, Miguel Araújo Vieira, Romana Carisa Carvalho da Fonseca, Diogo Miranda Gonçalves Guimarães dos Santos, Joana Patrícia Abelha Aleixo Pinto, Sandra Patrícia Abreu Monteiro |
author_sort | Guerra, Miguel Gomes |
collection | PubMed |
description | BACKGROUND: Leprosy typically manifests with skin and peripheral nerve involvement. Musculoskeletal complaints are the third most common, and can be the sole presenting manifestation. They range from arthralgia/arthritis in reactional states to full mimics of systemic rheumatic diseases. Remitting Seronegative Symmetrical Synovitis with Pitting Oedema syndrome has only been described once in a patient with already diagnosed Leprosy. CASE REPORT: A 68-year-old male, from an endemic region of familial amyloid polyneuropathy, presented with an inaugural Remitting Seronegative Symmetrical Synovitis with Pitting Oedema like syndrome, more that 20 years after travelling to Leprosy endemic areas. Arthritis would resurface whenever oral prednisone was tapered, so methotrexate was started, controlling the complaints. Only one year later, after the appearance of peripheral neuropathy and skin lesions, it was possible to diagnose Leprosy, through the identification of Mycobacterium leprae bacilli in a peripheral nerve biopsy. CONCLUSION: This report is an example of the heterogeneity of manifestations of Leprosy, namely rheumatic, and the challenge of diagnosing it when typical complaints are absent. It is also a reminder that this disease should be considered whenever a patient with a combination of skin/neurologic/rheumatic complaints has travelled to endemic countries in the past. |
format | Online Article Text |
id | pubmed-6530132 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-65301322019-05-28 Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report Guerra, Miguel Gomes Videira, Taciana Marta Ferreira Cardoso Morais, Hugo Alexandre Gomes Santos, Telma Cristiana Resse Nunes Taipa, Ricardo Jorge Ferreira Abreu, Miguel Araújo Vieira, Romana Carisa Carvalho da Fonseca, Diogo Miranda Gonçalves Guimarães dos Santos, Joana Patrícia Abelha Aleixo Pinto, Sandra Patrícia Abreu Monteiro BMC Infect Dis Case Report BACKGROUND: Leprosy typically manifests with skin and peripheral nerve involvement. Musculoskeletal complaints are the third most common, and can be the sole presenting manifestation. They range from arthralgia/arthritis in reactional states to full mimics of systemic rheumatic diseases. Remitting Seronegative Symmetrical Synovitis with Pitting Oedema syndrome has only been described once in a patient with already diagnosed Leprosy. CASE REPORT: A 68-year-old male, from an endemic region of familial amyloid polyneuropathy, presented with an inaugural Remitting Seronegative Symmetrical Synovitis with Pitting Oedema like syndrome, more that 20 years after travelling to Leprosy endemic areas. Arthritis would resurface whenever oral prednisone was tapered, so methotrexate was started, controlling the complaints. Only one year later, after the appearance of peripheral neuropathy and skin lesions, it was possible to diagnose Leprosy, through the identification of Mycobacterium leprae bacilli in a peripheral nerve biopsy. CONCLUSION: This report is an example of the heterogeneity of manifestations of Leprosy, namely rheumatic, and the challenge of diagnosing it when typical complaints are absent. It is also a reminder that this disease should be considered whenever a patient with a combination of skin/neurologic/rheumatic complaints has travelled to endemic countries in the past. BioMed Central 2019-05-22 /pmc/articles/PMC6530132/ /pubmed/31117984 http://dx.doi.org/10.1186/s12879-019-4098-9 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Case Report Guerra, Miguel Gomes Videira, Taciana Marta Ferreira Cardoso Morais, Hugo Alexandre Gomes Santos, Telma Cristiana Resse Nunes Taipa, Ricardo Jorge Ferreira Abreu, Miguel Araújo Vieira, Romana Carisa Carvalho da Fonseca, Diogo Miranda Gonçalves Guimarães dos Santos, Joana Patrícia Abelha Aleixo Pinto, Sandra Patrícia Abreu Monteiro Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report |
title | Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report |
title_full | Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report |
title_fullStr | Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report |
title_full_unstemmed | Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report |
title_short | Leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report |
title_sort | leprosy presenting as remitting seronegative symmetrical synovitis with pitting oedema syndrome – a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6530132/ https://www.ncbi.nlm.nih.gov/pubmed/31117984 http://dx.doi.org/10.1186/s12879-019-4098-9 |
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