New insights at the interface between leprosy and immune-mediated rheumatic diseases

Vitor Alves Cruz; Cleandro Pires de Albuquerque; Maria Fernanda Brandão de Resende Guimarães; Carla da Fontoura Dionello; Sandra Lúcia Euzébio Ribeiro; Viviane Angelina de Souza; Ciro Martins Gomes; Licia Maria Henrique da Mota

doi:10.3389/fmed.2023.1239775

New insights at the interface between leprosy and immune-mediated rheumatic diseases

Front Med (Lausanne). 2023 Sep 25:10:1239775. doi: 10.3389/fmed.2023.1239775. eCollection 2023.

Authors

Vitor Alves Cruz¹, Cleandro Pires de Albuquerque², Maria Fernanda Brandão de Resende Guimarães³, Carla da Fontoura Dionello⁴, Sandra Lúcia Euzébio Ribeiro⁵, Viviane Angelina de Souza⁶, Ciro Martins Gomes⁷, Licia Maria Henrique da Mota²

Affiliations

¹ Federal University of Goiás, Goiás, Brazil.
² Department of Rheumatology, University of Brasilia, Brasilia, Brazil.
³ Department of Rheumatology, Federal University of Minas Gerais, Belo Horizonte, Brazil.
⁴ Department of Rheumatology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
⁵ Department of Rheumatology, Federal University of Amazonas, Manaus, Brazil.
⁶ Department of Rheumatology, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
⁷ Department of Dermatology, University of Brasilia, Brasilia, Brazil.

Abstract

Leprosy is an infectious and contagious disease of slow evolution, triggered by Mycobacterium leprae. Arthritis is its third most common manifestation, after cutaneous and peripheral nerve involvement. Since musculoskeletal symptoms may be the initial presentation of the disease, it is important for health professionals to recognize its rheumatic manifestations for early diagnosis and appropriate treatment, especially in endemic areas. In addition, cases of leprosy have increased globally, notably in patients undergoing treatment with TNF-α blockers and due to the increase in migration and travel of people from developing countries to developed countries. This review proposes to discuss the main scenarios of mimicry of different rheumatic diseases by leprosy, as well as the role of immunosuppressive drugs used in rheumatology practice in the treatment of reactional states and in the risk of developing the infection.

Keywords: Mycobacterium leprae; SLE; leprosy; rheumatic dieases; rheumatoid arthritis.

Publication types

Review