Type 2 leprosy reaction presenting as a monoarthritis post multidrug therapy

Isabela Maria Bernardes Goulart; Marcela Araujo de Oliveira Santana; Willian Vargas Tenório da Costa; Matthew Martin Pavelka; Bruno de Carvalho Dornelas

doi:10.1016/j.idcr.2022.e01386

Type 2 leprosy reaction presenting as a monoarthritis post multidrug therapy

IDCases. 2022 Jan 6:27:e01386. doi: 10.1016/j.idcr.2022.e01386. eCollection 2022.

Authors

Isabela Maria Bernardes Goulart^{1

2

3}, Marcela Araujo de Oliveira Santana³, Willian Vargas Tenório da Costa¹, Matthew Martin Pavelka⁴, Bruno de Carvalho Dornelas¹

Affiliations

¹ School of Medicine, Federal University of Uberlândia (UFU), 1720, Pará avenue, Uberlândia, MG, Brazil.
² Postgraduate Program in Health Sciences, School of Medicine, Federal University of Uberlândia (UFU), 94, Capricórnio Street, Uberlândia, MG, Brazil.
³ National Reference Center for Sanitary Dermatology and Leprosy, School of Medicine, Federal University of Uberlândia (UFU), 94, Capricórnio Street, Uberlândia, MG, Brazil.
⁴ Indiana University School of Medicine, 620 N. Chestnut Street Holmstedt Hall 135, Terre Haute, IN 47809, USA.

Abstract

Type 2 leprosy reaction, or erythema nodosum leprosum (ENL), involves a complex interaction between the host's immune system and Mycobacterium leprae. It may occur before, during, or after treatment and have a variable clinical presentation involving different body systems, such as skin, osteoarticular, kidneys, and others. Thus, the differential diagnosis, depending on its clinical presentation, can be broad and challenging. The authors report a case of a severe monoarthritis during a type 2 reaction after the multidrug therapy (MDT) was discharged and the investigation of the differential diagnoses.

Keywords: Arthritis; Erythema nodosum; Leprosy; Mycobacterium leprae.

Publication types

Case Reports