Santacruz Juan Camilo, Mantilla Marta Juliana, Pulido Sandra, Agudelo Carlos Alberto, Londoño Juan Diego, Londono John
Spondyloarthropathies Research Group, Universidad de La Sabana, Chía, COL.
Rheumatology Department, Centro de Investigación en Reumatología y Especialidades Médicas (CIREEM), Bogotá, COL.
Cureus. 2024 Sep 20;16(9):e69788. doi: 10.7759/cureus.69788. eCollection 2024 Sep.
Although human immunodeficiency virus (HIV)-associated arthropathy is the most frequently described joint syndrome, the spectrum of its clinical manifestations is poorly known, and it is difficult to distinguish it from reactive arthritis (ReA). Knowing how to differentiate these two conditions has major implications regarding their prognosis and treatment. We present the case of an adult patient with a history of HIV infection with adequate virological control and good adherence to antiretroviral treatment, which began with an acute clinical picture consisting of additive asymmetric oligoarthritis with subsequent transition to symmetric polyarthritis predominantly in the upper extremities, initially attributed to ReA. Finally, his immunoserological profile was determined with negative results for rheumatoid factor, anti-citrulline antibodies, and human leukocyte antigen B27, achieving complete resolution of joint symptoms five weeks after treatment with nonsteroidal anti-inflammatory drugs, hydroxychloroquine, and intermediate doses of glucocorticoids, establishing the diagnosis of HIV-associated arthropathy.
尽管人类免疫缺陷病毒（HIV）相关关节病是最常被描述的关节综合征，但其临床表现谱却鲜为人知，而且很难将其与反应性关节炎（ReA）区分开来。了解如何区分这两种情况对它们的预后和治疗具有重要意义。我们报告一例成年患者，有HIV感染病史，病毒学控制良好且对抗逆转录病毒治疗依从性良好，该患者起初表现为急性临床症状，包括叠加性非对称性寡关节炎，随后转变为主要累及上肢的对称性多关节炎，最初被归因于ReA。最后，对其进行了免疫血清学检查，类风湿因子、抗瓜氨酸抗体和人类白细胞抗原B27结果均为阴性，在使用非甾体类抗炎药、羟氯喹和中等剂量糖皮质激素治疗五周后关节症状完全缓解，从而确诊为HIV相关关节病。
