A Case of Visceral Leishmaniasis Presenting as Seropositive Erosive Rheumatoid Arthritis in an Immunocompromised Patient
November 2024
in “
Rheumatology Advances in Practice
”
TLDR Visceral leishmaniasis can mimic rheumatoid arthritis symptoms, especially in immunocompromised patients.
This case study discusses a 46-year-old Caucasian male with HIV and hepatitis B who initially presented with symptoms similar to seropositive erosive rheumatoid arthritis but was ultimately diagnosed with visceral leishmaniasis. The patient showed skin nodules, arthralgia, and weight loss, with positive rheumatoid factor, anti-CCP, and ANA antibodies. Initial treatment for rheumatoid arthritis was ineffective, leading to further investigation that confirmed visceral leishmaniasis through biopsies and blood tests. Treatment with amphotericin B and miltefosine resulted in significant improvement. The case emphasizes the complexity of diagnosing autoimmune diseases in the presence of chronic infections, especially in immunocompromised patients, and the need for considering travel history and a multidisciplinary diagnostic approach.
