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类结节病样的界线类偏结核样型麻风:一例报告

Borderline tuberculoid leprosy mimicking sarcoidosis: A case report.

作者信息

Liu Jian, Wen Yan, Xing Yan, Wang Shuo

机构信息

Beijing Tropical Medicine Research Institute, Beijing Friendship Hospital Beijing Key Laboratory for Research on Prevention and Treatment of Tropical Diseases (BZ0086), Capital Medical University, Beijing, China Pacific Institute of Medical Sciences, Bothell, Washington.

出版信息

Medicine (Baltimore). 2018 Aug;97(32):e11616. doi: 10.1097/MD.0000000000011616.

Abstract

INTRODUCTION

Leprosy is a chronic infectious granulomas disease caused by Mycobacterium leprae that can manifest as a wide variety of immunological and clinical features.

CASE SUMMARY

Here, we describe the case of a woman with clinical characteristics of borderline tuberculoid (BT) leprosy that manifested as 3 asymmetric skin lesions involving her hip and lower limbs. This unusual presentation was initially misdiagnosed as sarcoidosis because noncaseating granulomas are a histopathological feature of both diseases. Differentiation and the diagnosis of BT leprosy was achieved using real-time polymerase chain reaction (PCR) to amplify an M leprae specific DNA sequence and to detect serum antibodies specific to M leprae antigens. Accordingly, a 6-month course of multidrug therapy led to a marked improvement in the skin lesions.

CONCLUSION

The use of auxiliary tests including real-time PCR to amplify an M leprae-specific DNA sequence, enzyme-linked immunosorbent assay, and dipstick detection of serum antibodies specific to M leprae antigens are good methods to obtain a correct diagnosis of BT leprosy.

摘要

引言

麻风病是一种由麻风分枝杆菌引起的慢性感染性肉芽肿疾病,可表现出多种免疫学和临床特征。

病例摘要

在此,我们描述了一名具有边缘结核样(BT)麻风病临床特征的女性病例,其表现为累及臀部和下肢的3处不对称皮肤损害。这种不寻常的表现最初被误诊为结节病,因为非干酪样肉芽肿是这两种疾病的组织病理学特征。通过实时聚合酶链反应(PCR)扩增麻风分枝杆菌特异性DNA序列并检测针对麻风分枝杆菌抗原的血清抗体,实现了BT麻风病的鉴别与诊断。据此,6个月的多药治疗疗程使皮肤损害有了显著改善。

结论

使用包括实时PCR扩增麻风分枝杆菌特异性DNA序列、酶联免疫吸附测定以及检测针对麻风分枝杆菌抗原的血清抗体的试纸条检测等辅助检查,是获得BT麻风病正确诊断的良好方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e569/6133579/56f607784fd6/medi-97-e11616-g001.jpg

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