Garg G, Gogia A, Kakar A
Indian J Lepr. 2016 Apr;88(2):123-127.
Leprosy may mask a variety of diseases. One such disease is systemic lupus erythematosus. The early differentiation between the two diseases is of utmost importance to institute appropriate treatment and reduce patient morbidity and mortality. Leprosy is a communicable, chronic granulomatous disease caused by Mycobacterium leprae. This clinically manifests predominantly with neurological and cutaneous features. However, it may also manifest with a variety of autoimmune phenomena indicative of autoimmune diseases, such as Systemic Lupus Erythematosus (SLE) or Rheumatoid Arthritis. Infection with Mycobocterium leprae not only mimics lupus flares, but possibly may also act as a trigger for lupus reactivation; however, its relationship is still not fully understood and explored. We report a case that was diagnosed as leprosy but retrospective analysis revealed that it was probablythe initial manifestations of Lupus. During hospitalization the patient suddenly developed hypoxia and was found to have pulmonary haemorrhage. He was successfully managed with steroids, Mycophenolatemofetil along with other supportive treatment. Our case highlights the rare presentation of pulmonary haemorrhage in a male lupus patient and focuses on leprosy mimicking lupus.
麻风可能掩盖多种疾病。其中一种疾病是系统性红斑狼疮。这两种疾病的早期鉴别对于制定恰当的治疗方案以及降低患者的发病率和死亡率至关重要。麻风是由麻风杆菌引起的一种传染性慢性肉芽肿疾病。其临床表现主要为神经和皮肤症状。然而,它也可能表现出各种提示自身免疫性疾病的自身免疫现象,如系统性红斑狼疮(SLE)或类风湿关节炎。感染麻风杆菌不仅会模仿狼疮发作,还可能触发狼疮复发;然而,其关系仍未得到充分理解和探究。我们报告一例最初被诊断为麻风但回顾性分析显示可能是狼疮首发表现的病例。住院期间患者突然出现缺氧并被发现有肺出血。通过使用类固醇、霉酚酸酯以及其他支持性治疗,他得到了成功救治。我们的病例突出了男性狼疮患者肺出血这种罕见表现,并聚焦于麻风模仿狼疮的情况。