Rheumatologic manifestations of pediatric HIV infection

In order to assess the frequency of rheumatologic manifestations at differe nt stages of pediatric human immunodeficiency virus (HIV) infection, 26 HIV -infected children at any stage of infection, seen at the Children's AIDS C linic of "La Raza" National Medical Center from January 1997 to December 19 98, were studied. Rheumatologic manifestations were assessed following the criteria established by the American College of Rheumatology. Blood samples were taken for measuring CD4(+) and CD8(+) T cells, antinuclear antibodies (ANA), anticardiolipin (ACL) antibodies, and rheumatoid factor (RF). The r esults were compared to those of 25 HIV-negative children of similar ages. Rheumatologic manifestations were identified in 5 (19.2%) of 26 children. T wo of whom were twin sisters with biphasic Raynaud's syndrome, and one had necrosing vasculitis of a finger, as well as lip necrosis and livedo reticu laris. These patients were positive for ANA and ACL. One case each of knee arthalgias, vasculitis, and septic arthritis of the ankle were also seen. A ll of the rheumatologic manifestations were in advanced stages of HIV disea se. These rheumatologic changes are similar to those reported for HIV- posi tive adults, and should be considered as part of the HIV acquired immune de ficiency syndrome (AIDS) clinical spectrum in the pediatric population.