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

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。

Objective To emphasize the recognition of leprosy with joint symptoms or positive rheumatoid factor （RF）. Methods Clinical manifestations , laboratory results and image information of 3 cases of leprosy misdiagnosed as rheumatoid arthritis were analysed retrospectively , and the related literatures were reviewed. Results Among 3 patients, 2 were male and 1 was female;2 patients showed joint symptoms, 2 were with positive RF, and 3 with in- creased levels of erythrocyte sedimentation rate and C-reactive protein; these patients were all misdiagnosed as rheu- matoid arthritis for 3 - 5 years. Conclusion The possibility of leprosy should be considered when patients are with joint symptoms or positive RF complicated with skin lesions and peripheral neuropathy.