Gibson T
Guy's Hospital, London, UK.
Baillieres Clin Rheumatol. 1995 Feb;9(1):179-91. doi: 10.1016/s0950-3579(05)80154-2.
Arthritis is a common feature of leprosy and contributes to disability. Direct invasion of joints and bones by mycobacteria may lead to a destructive arthritis in lepromatous disease. The infective process may involve few or many joints. Reactional states may occur spontaneously but usually after the initiation of anti-mycobacterial treatment. In both the type 1 reaction of borderline case and the type 2 reaction of the lepromatous disease, intense inflammation may occur at sites of infection. The immunology of the reactions is different but they share clinical features including a polyarthritis which may resemble rheumatoid disease. The joint disease may be chronic or relapsing, affecting the wrists and small joints of the hands in particular. Radiological erosions may occur. Mycobacterium leprae is not found in the synovium in this pattern of arthritis. Further study of this phenomenon might yield useful information above the mechanism of joint inflammation in other rheumatic diseases.
关节炎是麻风病的常见特征，也是导致残疾的原因之一。分枝杆菌直接侵袭关节和骨骼可能会导致瘤型麻风病出现破坏性关节炎。感染过程可能累及少数或多个关节。反应状态可能自发出现，但通常在开始抗分枝杆菌治疗后发生。在界线类病例的1型反应和瘤型麻风病的2型反应中，感染部位均可能出现强烈炎症。两种反应的免疫学机制不同，但它们具有共同的临床特征，包括可能类似于类风湿病的多关节炎。关节疾病可能是慢性的或复发的，尤其会影响手腕和手部的小关节。可能会出现放射学侵蚀。在这种关节炎模式的滑膜中未发现麻风分枝杆菌。对这一现象的进一步研究可能会为其他风湿性疾病中关节炎症的机制提供有用信息。
