van der Laan Willemijn H, Faber William R, de Vries Niek, Maas Mario, Tak Paul Peter
Academisch Medisch Centrum/Universiteit van Amsterdam, Amsterdam, The Netherlands.
Ned Tijdschr Geneeskd. 2009;153:A246.
Rheumatoid arthritis was diagnosed in a 65-year-old man from Suriname, on the basis of clinical and radiological findings. However, he was eventually diagnosed with leprosy. This emerged when the patient developed skin lesions and complained of increasing sensibility disorders during treatment for the alleged rheumatoid arthritis. He was treated with a combination therapy consisting of rifampicin, clofazimine, dapsone, and prednisone. The skin lesions and joint symptoms were resolved as a result of this, but the sensibility disorders persisted. As physicians are not sufficiently familiar with leprosy and the condition has many manifestations that can mimic more frequently occurring diseases, leprosy is often diagnosed at a later stage. This may result in irreversible damage, especially to the peripheral nerves, which may lead to disability. Therefore, for patients who originate from areas where leprosy is endemic and who suffer from joint complaints in combination with skin or sensibility disorders, the diagnosis of leprosy should be considered.
一名来自苏里南的65岁男子，根据临床和放射学检查结果被诊断为类风湿性关节炎。然而，他最终被诊断为麻风病。这一诊断是在患者接受所谓类风湿性关节炎治疗期间出现皮肤病变并抱怨感觉障碍加重时得出的。他接受了由利福平、氯法齐明、氨苯砜和泼尼松组成的联合治疗。结果，皮肤病变和关节症状得到缓解，但感觉障碍仍然存在。由于医生对麻风病不够熟悉，而且这种疾病有许多表现可能会模仿更常见的疾病，麻风病往往在较晚阶段才被诊断出来。这可能会导致不可逆转的损害，尤其是对周围神经，可能导致残疾。因此，对于来自麻风病流行地区且患有关节疾病并伴有皮肤或感觉障碍的患者，应考虑诊断为麻风病。
