Section of Rheumatology and Laboratory, Instituto Municipal de Rehabilitación Psicofísica (M.G.R., L.A.P., S.D.R., M.A.M., J.A.M.C.); Department of Infectology, Hospital "Evita" de Lanús, (D.S., C.P.) Buenos Aires, Argentina.
J Clin Rheumatol. 1996 Jun;2(3):125-8. doi: 10.1097/00124743-199606000-00003.
This study involved 50 human immunodeficiency virus (HIV)-positive patients in various stages of the disease to identify signs and symptoms suggestive of rheumatologic disorders and to determine how frequently such findings mimic rheumatologic pictures. Control subjects were 25 ambulatory HIV-negative patients with similar risk factors, mostly drug abuse. Although arthralgias and myalgias were reported in both groups, arthritis was only detected in the HIV-positive group. Twenty-four HIV cases presented two or more signs or symptoms suggestive of rheumatic disorders versus only six non-HIV cases (p < 0.04). Some features were suggestive of systemic lupus erythematosus, vasculitis-panarteritis nodosa, Sjögren's syndrome, Behcet's syndrome and rheumatoid arthritis, although no patients met criteria for these diseases. Reiter's syndrome was diagnosed in two (4%) HIV-positive patients. On correlating CD4 lymphocyte levels and rheumatic symptomatology, the more severely immunocompromised cases were found to present musculoskeletal manifestations with greater frequency. Potential HIV infection should be considered in differential diagnosis of questionable cases of rheumatic disease to avoid both misdiagnosis and the institution of therapies liable to worsen the immunodeficiency syndrome.
本研究纳入了 50 名处于不同疾病阶段的人类免疫缺陷病毒（HIV）阳性患者，以确定提示风湿性疾病的体征和症状，并确定这些发现与风湿性疾病图像相似的频率。对照组为 25 名有类似风险因素的门诊 HIV 阴性患者，主要为滥用药物者。虽然两组均报告有关节痛和肌痛，但仅在 HIV 阳性组中检测到关节炎。24 例 HIV 病例出现两种或多种提示风湿性疾病的体征或症状，而非 HIV 病例仅 6 例（p < 0.04）。一些特征提示系统性红斑狼疮、血管炎-多动脉炎结节、干燥综合征、贝赫切特综合征和类风湿关节炎，尽管没有患者符合这些疾病的标准。两名（4%）HIV 阳性患者被诊断为赖特综合征。在将 CD4 淋巴细胞水平与风湿性症状相关联时，发现免疫功能越严重受损的病例，肌肉骨骼表现出现的频率越高。在有疑问的风湿性疾病的鉴别诊断中，应考虑到潜在的 HIV 感染，以避免误诊和采用可能加重免疫缺陷综合征的治疗方法。
