By Nancy E. Lane (auth.), Nancy E. Lane (eds.)
In Aids allergic reaction and Rheumatology, medical specialists survey the most recent info to be had at the key rheumatic and allergic matters that physicians face in treating the HIV-infected sufferer. Their articles specialize in the rheumatologic and dermatologic manifestations of HIV-1 an infection, which come with arthritis, myopathies, vasculitis, sicca syndrome, different autoimmune phenomena, and psoriasis. in addition they learn the query of allergy symptoms in HIV sufferers, together with drug allergy, with particular cognizance given to antagonistic reactions to trimethoprim-sulfamethoxazole, the main often prescribed anti-infective. sensible recommendation for the prognosis and therapy of those difficulties is given in complete.
Aids allergic reaction and Rheumatology bargains physicians a entire consultant to the prognosis and therapy of the allergic, immunologic, and rheumatic issues in HIV sufferers. Authoritative and practice-oriented, the publication is destined to turn into a customary source for all these treating AIDS sufferers today.
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Additional resources for AIDS Allergy and Rheumatology
No specific therapy is usually needed in these cases. 46 Kaye Primary Angiitis of the Central Nervous System Primary angiitis of the central nervous system is an extremely rare disorder. Six of the 108 cases reported in the English literature through January 1990 have been in HIV-infected individuals (103). Fulminant central nervous system symptoms occur, with histology revealing granulomatous involvement of cerebral arteries. Systemic necrotizing vasculitic symptoms, such as skin lesions, abdominal pain, foot and wrist drop, hematuria, and proteinuria, are absent.
All patients tested negative for the HLA-B27 antigen, rheumatoid factor, and antinuclear antibodies (26). Similar cases of HIV -associated arthritis have been subsequently described (1,12,27,28). Pathophysiology The pathophysiologic mechanism of HIV-associated arthritis is unknown. Low synovial leukocyte counts and tubuloreticular inclusions seen in some patients with HIV-associated arthritis by electron microscopy suggest a direct viral infection of the joint (26). Furthermore, not only have researchers isolated HIV from synovial fluid of HIV-infected individuals, but electron microscopy has revealed retroviral-like particles in the synovial fluid (27,28).
On the other hand, HIV antigens may be involved in the formation of antigen-antibody complexes causing vasculitis in a manner similar to that of hepatitis B surface antigen. Immunofluorescent studies performed in two cases of leukocytoclastic vasculitis occurring in HIV-infected individuals gave some indication of such immune complex mechanisms (103). The HIV virus may also have a direct effect on the blood vessel wall, thus causing vasculitis in some as yet unknown way (2). Calabrese et al. (107) cultured HIV from peripheral nerves of an HIV-infected patient with necrotizing vasculitis, but could not demonstrate HIV in the vasculitic infiltrates.