误诊为类风湿关节炎的麻风3例并文献复习

Leprosy misdiagnosed as rheumatoid arthritis: 3 case reports and review of the literature

摘要:

目的提高对有关节症状或类风湿因子（RF）阳性的麻风病的认识。方法回顾性分析3例误诊为类风湿关节炎的麻风患者的临床表现、实验室检查与影像学资料，并复习相关文献。结果3例患者中，2例男性，1例女性；2例有关节症状，2例RF阳性，3例血沉、C反应蛋白等炎性指标增高；误诊为类风湿关节炎的时间长达3~5年。结论对于合并皮肤、周围神经等系统损害的关节病变或RF阳性患者，应提高对麻风的警惕性，避免误诊、误治。

Abstract:

ObjectiveTo emphasize the recognition of leprosy with joint symptoms or positive rheumatoid factor (RF).MethodsClinical manifestations ,laboratory results and image information of 3 cases of leprosy misdiagnosed as rheumatoid arthritis were analysed retrospectively , and the related literatures were reviewed.ResultsAmong 3 patients, 2 were male and 1 was female;2 patients showed joint symptoms, 2 were with positive RF, and 3 with increased levels of erythrocyte sedimentation rate and Creactive protein; these patients were all misdiagnosed as rheumatoid arthritis for 3-5 years.ConclusionThe possibility of leprosy should be considered when patients are with joint symptoms or positive RF complicated with skin lesions and peripheral neuropathy.