PROGRESSIVE JOINT DESTRUCTION IN A HUMAN IMMUNODEFICIENCY VIRUS-INFECTED PATIENT WITH RHEUMATOID-ARTHRITIS

This article reports the case of a 63-year-old patient with rheumatoid arthritis (RA) whose symptoms of RA improved after the occurrence of a secondary human immunodeficiency virus (HIV) infection; however, the HIV infection did not affect the histologic parameters of joint destr uction to the same extent as it did the clinical symptoms. Histologic and immunohistologic joint examinations of this patient revealed an on going production of cartilage- and bone-degrading enzymes by macrophag es and fibroblasts, without the presence of T cells. These findings de monstrate that progressive joint destruction in RA can occur in the ab sence of T cells. Moreover, our results support the hypothesis that bo th T cell-dependent and T cell-independent pathways play a significant role in the pathogenesis of Ri.