Hansen’s disease (HD), or leprosy, is a chronic infectious disease caused by Mycobacterium leprae. It remains a public health concern in tropical regions like the Philippines. HD can present with a wide range of clinical manifestations and is often misdiagnosed, particularly as autoimmune disorders. This case report discusses a 20-year-old Filipino female initially misdiagnosed with Raynaud’s phenomenon, suspected to be due to an autoimmune condition.

Five years prior to her current presentation, the patient developed progressive swelling of her hands and feet, temperature-induced color changes, and facial erythema. Initial laboratory tests showed anemia, positive antinuclear antibody (ANA), and elevated complement (C3), suggesting a possible autoimmune disorder. A subsequent skin biopsy confirmed lepromatous leprosy with a bacillary index of 6+. Positive anticardiolipin and anti-beta2 glycoprotein 1 antibodies indicated a probable diagnosis of antiphospholipid syndrome (APS). These APS-like findings were thought to result from leprosy reactions and associated immune dysregulation. Due to rifampicin- and dapsone-induced hemolysis, the patient was treated with clofazimine, ofloxacin, clarithromycin, and oral steroids, resulting in clinical improvement after 12 months. Further hematologic evaluation was ongoing, as she was referred for blood dyscrasia.

Leprosy can mimic autoimmune diseases, as demonstrated by this case. Raynaud’s phenomenon and APS-like features may arise from immune dysregulation caused by chronic infection and leprosy reactions. The case highlights the complexity of diagnosing leprosy with autoimmune-like manifestations and emphasizes the importance of early diagnosis and tailored treatment to prevent complications from multisystem involvement.