Lupus-specific autoantibodies in concomitant human immunodeficiency virus and systemic lupus erythematosus: Case report and literature review

• Published in: Seminars in arthritis and rheumatism Vol. 30; no. 6; pp. 418 - 425
• Main Authors: Daikh, Brian E., Holyst, Margaret-Mary
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA Elsevier Inc 01-06-2001; Elsevier
• Subjects: acquired immunodeficiency syndrome; Adult; autoantibodies; Autoantibodies - analysis; Biological and medical sciences; Female; HIV Infections - complications; human immunodeficiency virus; Human viral diseases; Humans; Infectious diseases; Lupus Erythematosus, Systemic - complications; Lupus Erythematosus, Systemic - immunology; Medical sciences; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Systemic lupus erythematosus; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; human immunodeficiency virus; Systemic lupus erythematosus; autoantibodies; acquired immunodeficiency syndrome; Skin disease; Autoimmune disease; Specificity; Association; Systemic disease; Adult; Lupus erythematosus; Diagnosis; Disseminated; Human; Immunopathology; Connective tissue disease; Antibody; Retroviridae; Autoantibody; AIDS; Immune deficiency; Lentivirus; Infection; Virus; Case study; Symptomatology; Viral disease; Human immunodeficiency virus; Bibliographic review
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1053/sarh.2001.23149

Objectives: To report a case of systemic lupus erythematosus (SLE) in a patient with human immunodeficiency virus (HIV) infection. We also reviewed the medical literature for similar cases to assess the role of “lupus-specific antibodies” in the diagnosis of SLE in the presence of HIV infection. Methods: We described the presentation, clinical course, and serologic studies of our patient and reviewed the English language medical literature from 1966 to 1999 using MEDLINE with the keywords “SLE,” “HIV,” “acquired immune deficiency syndrome (AIDS),” and “autoantibodies.” Results: Our patient with long-standing HIV infection presented with fever, arthralgias and arthritis, photosensitive rash, oral ulcers, alopecia, headache, pleuritic chest pain, and lymphadenopathy. Laboratory testing showed leukopenia, thrombocytopenia, antibodies against ribonucleoprotein, Smith, and ribosomal-P, as well as immunoglobulin G anticardiolipin antibodies. Review of the literature revealed only 25 cases of concomitant SLE and HIV. In these cases, rheumatologic signs and symptoms were common in HIV and overlapped significantly with SLE. Autoantibodies also occurred frequently in both diseases. Conclusions: There are very few reported cases of concomitant HIV and SLE. These diseases may be largely mutually exclusive, but distinguishing the two can be difficult because of the high degree of rheumatic complaints and autoantibodies in HIV-positive patients. As illustrated by the patient presented, SLE should be considered in HIV-positive patients with rheumatologic complaints. Semin Arthritis Rheum 30:418-425. Copyright © 2001 by W.B. Saunders Company