Gibson T, Ahsan Q, Hussein K
Department of Medicine, Aga Khan University Hospital, Karachi, Pakistan.
Br J Rheumatol. 1994 Oct;33(10):963-6. doi: 10.1093/rheumatology/33.10.963.
An inflammatory polyarthritis has been previously described in leprosy but accounts of the clinical characteristics have varied. All patients with joint symptoms admitted to a leprosy centre over 5 months were examined by a rheumatologist. Of 48 acute admissions, 20 (42%) had a symmetrical polyarthritis affecting the wrists and fingers. This was strikingly similar to RA in appearance. The arthritis occurred exclusively in patients with reactions mainly during anti-mycobacterial treatment. The clinical features of the joint disorder were identical in Type I (associated with alterations in immune status) and Type II (erythema nodosum leprosum) reactions. Synovial tissue from one patient revealed no mycobacteria. Four of five hand X-rays suggested small erosions of the finger joints.
先前已有文献描述麻风病患者可出现炎性多关节炎，但关于其临床特征的报道各不相同。在5个月内入住麻风病中心的所有有关节症状的患者均由一名风湿病学家进行检查。在48例急性入院患者中，20例（42%）出现累及手腕和手指的对称性多关节炎。其外观与类风湿关节炎极为相似。关节炎仅发生在主要为抗分枝杆菌治疗期间出现反应的患者中。Ⅰ型（与免疫状态改变相关）和Ⅱ型（麻风结节性红斑）反应患者的关节疾病临床特征相同。一名患者的滑膜组织中未发现分枝杆菌。五份手部X光片中的四份显示手指关节有小的侵蚀。
