Division of Rheumatology, Department of Medicine, University of Puerto Rico Medical Sciences Campus, San Juan, Puerto Rico.
Lupus. 2012 Jul;21(8):900-4. doi: 10.1177/0961203311434106. Epub 2012 Jan 16.
The coexistence of human immunodeficiency virus (HIV) infection and systemic lupus erythematosus (SLE) is unusual, but the occurrence of SLE after HIV infection is even less common. Both conditions share similar clinical features including constitutional symptoms, facial rash, oral ulcers, alopecia, arthralgias, arthritis, seizures, cytopenias, glomerulonephritis, and antinuclear and antiphospholipid antibodies. This clinical overlap makes the diagnosis of SLE in a patient with pre-existing HIV infection difficult. Furthermore, immune complex glomerulonephritis with features resembling lupus nephritis has been described in HIV-positive patients. We present the case of a 45-year-old Hispanic woman with long-standing HIV infection who developed membranous glomerulonephritis with histological features of lupus nephritis. Five years after onset of renal disease she developed clinically evident SLE.
人类免疫缺陷病毒 (HIV) 感染和系统性红斑狼疮 (SLE) 同时存在并不常见，但 HIV 感染后发生 SLE 则更为罕见。这两种疾病具有相似的临床特征，包括全身症状、皮疹、口腔溃疡、脱发、关节痛、关节炎、癫痫发作、血细胞减少、肾小球肾炎以及抗核抗体和抗磷脂抗体。这种临床重叠使得在 HIV 感染患者中诊断 SLE 变得困难。此外，免疫复合物性肾小球肾炎伴狼疮肾炎样特征已在 HIV 阳性患者中被描述。我们报告了一例 45 岁的西班牙裔女性，她患有长期 HIV 感染，出现了膜性肾小球肾炎，其组织学特征类似于狼疮性肾炎。在肾脏疾病发病 5 年后，她出现了明显的临床 SLE。
