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Background: Due to the increase of HIV patients’ survival, rheumatologic symptoms associated with HIV such as septic arthritis, psoriatic arthritis and other manifestations have increased. Also, diseases such as systemic Lupus Erythematosus (SLE) and Rheumatoid Arthritis (RA) can be intensified during AIDS. Objectives: The aim of this cross-sectional study was to evaluate the prevalence and nature of rheumatologic manifestations in HIV positive patients, Tehran, Iran. Materials and Methods: This cross-sectional investigation was done on 200 HIV infected patients from 2009 to 2010. Demographic characteristics (age and sex), the route of HIV transmission and the duration of infection, existence of any concurrent infection such as hepatitis B (HBV) and hepatitis C (HCV) infections, last CD4 count, regimen and duration of the anti-retroviral therapy, presence of any musculoskeletal manifestation and joint disease and their quantity and quality were obtained. Patients were also examined by a clinician and information was recorded via checklists. Data were analyzed using SPSS software and reported as means and percentages. Results: Two hundred HIV patients including 153 male and 47 female participated in the study. Sixty three patients (31.5%) had musculoskeletal manifestations. The most prevalent complaints were arthralgia in 25 patients (39.7%), myalgia in seven patients (11.1%) and unspecified spondyloarthritis in four patients (6.3%). Also, a borderline association was observed between HBV-HIV co-infection and presence of musculoskeletal findings (P = 0.047). Conclusions: Considering the high prevalence of rheumatologic manifestations in patients with HIV/AIDS and its probable relation to the quality of life of patients, there is a pressing need for evaluating patients in this regard, especially among patients who are receiving highly active anti-retroviral therapy (HAART) and experience better clinical responses.

Renal tubular acidosis (RTA) may develop in a large population of patients with Sjogren’s syndrome (SS), but most of the subjects are asymptomatic. Here, we report a patient with known rheumatoid arthritis and symptoms of xerostomia, xerophthalmia and periodic paralysis. SS should be considered as a cause of RTA. The treatment of the underlying disorder may ameliorate the symptoms.

Complex regional pain syndrome type 1 (CRPS1) refers to a disorder usually caused by trauma; it is characterized by pain, swelling, limited range of motion, vasomotor instability, skin changes, joint stiffness, and patchy bone demineralization. Most often it occurs after trauma. Other etiologies include myocardial ischemia, cerebrovascular accidents, infection and emotional stress. We report a case of bilateral CRPS1 of the upper extremities in a 52-year-old woman suffering from major depressive disorder. She was complaining about her hands' stiffness and pain. She also reported swelling of both upper extremities and anhydrosis, thickening of the skin and muscle wasting, finger movement limitation, contracture of the digits and trophic skin changes. The diagnosis of CRPS1 was suspected, according to history, physical examination, radiographic changes and bone scintigraphy.