Rynes R I, Goldenberg D L, DiGiacomo R, Olson R, Hussain M, Veazey J
Department of Medicine, Albany Medical College, New York 12208.
Am J Med. 1988 May;84(5):810-6. doi: 10.1016/0002-9343(88)90057-5.
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.
4例人类免疫缺陷病毒（HIV）感染患者出现了亚急性少关节炎综合征。其中3例患有真正的获得性免疫缺陷综合征（AIDS），且所有患者均有淋巴细胞异常。关节炎的特点是3例患者有极度疼痛和功能障碍，1例有中度疼痛。膝关节和踝关节受累。症状在1至6周的时间内出现；对治疗反应迅速，尤其是对关节内注射皮质类固醇。尽管关节炎临床症状严重，但滑液无炎症，活检标本仅显示轻度慢性滑膜炎。病因无法明确。所有患者均未发现易引发反应性关节炎的感染，3例接受组织分型的患者HLA - B27阴性。包括HIV在内的病毒感染是一种可能的病因。与这4例患者不同的是，同期另外4例HIV感染患者出现了病因明确的关节炎。
