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The Co-occurrence of Reiter's Syndrome and Acquired Immunodeficiency

[+] Article, Author, and Disclosure Information

Grant support: by grants AI 19411, AM 35404, and U01 CA 35982 from the U.S. Public Health Service; a grant from the Arthritis Foundation Clinical Research Center; a grant from the Smart Foundation; the Milton Petrie Endowment; and the Klein Endowment.

▸Requests for reprints should be addressed to Robert Winchester, M.D.; Hospital for Joint Diseases, 301 East 17th Street; New York, NY 10003.

New York, New York

© 1987 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1987;106(1):19-26. doi:10.7326/0003-4819-106-1-19
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Thirteen patients who had the co-occurrence of severe Reiter's syndrome and the acquired immunodeficiency syndrome (AIDS) or its related 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.





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