01717nas a2200229   4500000000100000008004100001260001200042653002300054653001200077653001300089653002200102100001300124700001100137700001300148700001500161700002100176245009100197856008300288300001100371520109100382022001401473       2021                            d  c10/202110aEmergency medicine10aleprosy10aNeuritis10aPeripheral nerves1 aFilho FB1 aLima F1 aVoltan G1 ade Paula N1 aCipriani Frade M00aLeprosy case series in the emergency room: A warning sign for a challenging diagnosis.  uhttps://www.sciencedirect.com/science/article/pii/S1413867021001033?via%3Dihub  a1016343 a<p>Leprosy can be considered a dissimulated disease, mainly when presented as atypical cases leading to mistaken diagnosis at the emergency setting. Herein we report six patients referred to the emergence room with hypotheses of acute myocardial infarction and arterial and venous thrombosis, although with chronic neurological symptoms; the seventh patient was referred with a wrong suspicion of infected skin ulcer. Positive findings included hypo-anesthetic skin lesions and thickened nerves; 100% were negative for IgM anti-phenolic glycolipid-I, while 71.4%, 100% and 42.8% were positive for IgA, IgM and IgG Mce1A. RLEP-PCR was positive in all patients. Ultrasound of peripheral nerves showed asymmetric and focal multiple mononeuropathy for all patients. Unfortunately, in many patients leprosy is often misdiagnosed as other medical conditions for long periods thus delaying initiation of specific treatment. This paper is intended to increase physicians' awareness to recognize leprosy cases presented as both classical and unusual forms, including in emergency department.</p>  a1678-4391