Advertisement

Acquired immunodeficiency syndrome-associated arthritis

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      A subacute, oligoarthritic syndrome developed in four patients with human immunodeficiency virus (HIV) infection. Three had true acquired immunodeficiency syndrome (AIDS) and all had lymphocyte abnormalities. The arthritis was characterized by extreme pain and disability in three patients and moderate pain in one. Knees and ankles were affected. Symptoms developed over a one- to six-week interval; response to treatment was rapid, especially to intra-articular corticosteroids. Despite the clinical severity of the arthritis, synovial fluids were non-inflammatory and biopsy specimens revealed only mild chronic synovitis. A definite etiology could not be established. None of the patients had recognized infections predisposing to reactive arthritis, and the three patients who underwent tissue typing were HLA-B27-negative. A viral infection, including HIV, is a possible cause. In distinction to these four patients, arthritides with clearly established etiologies developed during this same time period in four other HIV-infected patients.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Winchester R
        • Bernstein DH
        • Fischer HD
        • Enlow R
        • Solomon G
        The co-occurrence of Reiter's syndrome and acquired immunodeficiency.
        Ann Intern Med. 1987; 106: 19-26
        • Ricciardi DD
        • Sepkowitz DV
        • Berkowitz LB
        • Bienenstock H
        • Maslow M
        Cryptococcal arthritis in a patient with acquired immune deficiency syndrome: case report and review of the literature.
        Arthritis Rheum. 1986; 29: S14
        • Lane HC
        • Masur H
        • Edgar LC
        • Whalen G
        • Rook AH
        • Fauci AS
        Abnormalities of B-cell activation and immunoregulation in patients with the acquired immunodeficiency syndrome.
        N Engl J Med. 1983; 309: 453-458
        • Rubenstein A
        • Small CB
        • Bernstein LJ
        Autobodies to T-cells in adult and pediatric AIDS.
        Ann NY Acad Sci. 1984; 437: 508-511
        • Dorsett B
        • Cronin W
        • Chuma V
        • et al.
        Anti-lymphocyte antibodies in patients with the acquired immune deficiency syndrome.
        Am J Med. 1985; 78: 621-626
        • Rubinstein P
        • Walker M
        • Mollen N
        • et al.
        Immunogenetic aspects of epidemic Kaposi's sarcoma in homosexual men.
        in: Friedman-Kien AE Laubenstein JL AIDS: the epidemic of Kaposi's sarcoma and opportunistic infections. Masson Publishing, New York1984: 139-145
        • Bloom EJ
        • Abrams DI
        • Rodgers G
        Lupus anticoagulant and the acquired immunodeficiency syndrome.
        JAMA. 1986; 256: 491-493
        • Cohen AJ
        • Philips TM
        • Kessler CM
        Circulating coagulation inhibitors in the acquired immunodeficiency syndrome.
        Ann Intern Med. 1986; 104: 175-180
        • Stimmer MM
        • Boylen T
        • Sharma OP
        • McGehee WG
        • Quismorio FF
        Anticardiolipin antibodies (ACA) in acquired immunodeficiency syndrome.
        Arthritis Rheum. 1987; 30: S54
        • Kopelman RD
        • Zolla-Pazngr S
        The differential diagnosis of acquired immunodeficiency syndrome (AIDS) includes systemic lupus erythematosus (SLE).
        Arthritis Rheum. 1987; 30: S15
        • Walsh CM
        • Nardi MA
        • Karpatkin S
        On the mechanism of thrombocytopenic purpura in sexually homosexual men.
        N Engl J Med. 1984; 31: 635-639
        • Savona S
        • Nardi MA
        • Lennette ET
        • et al.
        Thrombocytopenic purpura in narcotics addicts.
        Ann Intern Med. 1985; 102: 737-741
        • Dalakas MC
        • Pezeshkpour GH
        • Gravell M
        • Sever JL
        Polymyositis associated with AIDS retrovirus.
        JAMA. 1986; 256: 2381-2383
        • Ulirsch RC
        • Jaffe ES
        Sjogren's syndrome-like illness associated with the acquired immunodeficiency syndrome-related complex.
        Hum Pathol. 1987; 10: 1063-1068
        • Gordon JJ
        • Golbus J
        • Kurtides ES
        Chronic lymphadenopathy and Sjogren's syndrome in a homosexual man.
        N Engl J Med. 1984; 311: 1441-1442
        • Hoffman RA
        • Kung PC
        • Hansen WP
        • Goldstein G
        Simple and rapid measurement of human T lymphocytes and their subclasses in peripheral blood.
        in: 4th ed. Proc Natl Acad Sci USA. 77. 1980: 4914-4917
        • Harris EN
        • Gharavi AE
        • Patel SP
        • Hughes GRV
        Evaluation of the anti-cardiolipin antibody test: report of an international workshop held 4 April 1986.
        Clin Exp Immunol. 1987; 68: 215-222
        • Centers for Disease Control
        Classification system for human T-lymphotropic virus type III/lymphadenopathy-associated virus infections.
        Ann Intern Med. 1986; 105: 234-237
        • Harris EN
        • Gharavi AE
        • Boey ML
        Anti-cardiolipin antibodies: detection by radioimmunoassay and association with thrombosis in systemic lupus erythematosus.
        Lancet. 1983; II: 1211-1214
        • Withrington RH
        • Cornes P
        • Willie Jr, Harris
        • et al.
        Isolation of human immunodeficiency virus from synovial fluid of a patient with reactive arthritis.
        Br Med J. 1987; 294: 484
        • Onerheim RM
        • Wang N
        • Gilmore N
        • Jothy S
        Ultrastructural markers of lymph nodes in patients with acquired immune deficiency syndrome and in homosexual males with unexplained persistent lymphadenopathy.
        Am J Clin Pathol. 1984; 82: 280-288
        • Grimely PM
        • Schaff Z
        Significance of tubuloreticular inclusions in the pathobiology of human diseases.
        Patho Biol Annu. 1976; 6: 221-257
        • Gorkey F
        • Min KW
        • Sincovics JG
        • et al.
        Systemic lupus erythematosus and myxovirus.
        N Engl J Med. 1969; 280: 333
        • Berman A
        • Espinoza LR
        • Diaz J
        • et al.
        The rheumatologic manifestations of human immunodeficiency syndrome infection.
        Arthritis Rheum. 1988; 31: R38
        • Myers AR
        • Schumacher HR
        Arthritis of subacute bacterial endocarditis.
        Arthritis Rheum. 1976; 19: 813-814
        • Kopelman RG
        • Zolla-Pazner S
        Association of human immunodeficiency virus infection and autoimmune phenomena.
        Am J Med. 1988; 84: 82-88