Winchester R, Bernstein D H, Fischer H D, Enlow R, Solomon G
Ann Intern Med. 1987 Jan;106(1):19-26. doi: 10.7326/0003-4819-106-1-19.
Thirteen patients who had the co-occurrence of severe Reiter's syndrome and the acquired immunodeficiency syndrome (AIDS) or its syndromes were studied. The arthritis was reactive in three patients and without defined cause in the others. Nine patients had HLA-B27. The two syndromes appeared simultaneously in four patients, suggesting a common biologic process, and in the others the immunodeficiency either preceded or followed the arthritis. Reiter's syndrome occurring in the setting of this profound immunodeficiency suggests that helper T cells were not involved in the pathogenesis of the rheumatic disease. Difficulties were encountered in the diagnosis of either syndrome in the presence of the other. Two patients with Reiter's syndrome developed Kaposi's sarcoma and fulminant AIDS after receiving methotrexate, which emphasizes the need for caution in the use of immunosuppressive therapy in Reiter's syndrome. An additional patient with undifferentiated spondylarthropathy subsequently developed psoriasis in conjunction with the onset of AIDS.
对13例同时患有严重赖特综合征和获得性免疫缺陷综合征（艾滋病）或其综合征的患者进行了研究。3例患者的关节炎具有反应性，其他患者的关节炎病因不明。9例患者携带HLA - B27。4例患者的两种综合征同时出现，提示存在共同的生物学过程，其他患者的免疫缺陷在关节炎之前或之后出现。在这种严重免疫缺陷情况下发生的赖特综合征提示辅助性T细胞不参与风湿性疾病的发病机制。在存在另一种综合征的情况下，诊断其中任何一种综合征都存在困难。2例赖特综合征患者在接受甲氨蝶呤治疗后发生了卡波西肉瘤和暴发性艾滋病，这强调了在赖特综合征中使用免疫抑制疗法时需要谨慎。另外1例未分化脊柱关节病患者在艾滋病发病时随后出现了银屑病。
