Elevated cerebrospinal fluid levels of substance P in patients with the fibromyalgia syndrome.

OBJECTIVE: To measure, and seek clinical correlates with, levels of substance P (SP) in the cerebrospinal fluid (CSF) of fibromyalgia syndrome (FMS) patients. METHODS: CSF from 32 FMS patients and 30 normal control subjects was tested for SP by radioimmunoassay. Clinical measures included tender point examination and standardized questionnaires. RESULTS: CSF SP levels were 3-fold higher in FMS patients than in normal controls (P < 0.001), but they correlated only weakly with tenderness found on examination. CONCLUSION: SP is significantly elevated in FMS CSF, but other abnormalities must exist in FMS to more fully explain the symptoms.

Rheumatic manifestations in human immunodeficiency virus positive and negative individuals: a study of 2 populations with similar risk factors.

OBJECTIVE: Assess the impact of human immunodeficiency virus (HIV) infection on the onset of rheumatic manifestations in HIV+ patients, and to compare them with a control HIV- group with similar risk factors. METHODS: We prospectively studied 74 consecutive HIV+ patients, looking for clinical and laboratory findings of rheumatic manifestations and compared them with 72 control subjects with similar risk factors for HIV who tested negative for HIV. RESULTS: Rheumatic manifestations were more frequently observed in the HIV+ group than the HIV-group (p < 0.001): Arthralgias were found in 34 (45%), arthritis in 8 (10%), and Reiter's syndrome in 6 (8%). Laboratory findings revealed rheumatoid factor in 16 (21%) HIV+ vs 2 (2%) in HIV-, antinuclear antibodies in 13 (17%) HIV+ vs 0 in HIV-, IgG anticardiolipin antibodies in 70 (94%) HIV+ vs 7 (9%) in HIV- (p < 0.001). Hyperuricemia was found in 31 HIV+ patients (41%), and hypouricemia in 4 (5%), compared with none in the HIV- group (p < 0.0001). Neoplasia were identified in 13 HIV+ patients, in 7 associated with hyperuricemia and 3 with hypouricemia. Of interest, 2 patients had urate abnormalities before the diagnosis of neoplasia. CONCLUSIONS: Our study suggests that rheumatic manifestations are more prevalent in HIV+ patients. In advanced HIV infection, hypo and hyperuricemia may be considered markers of neoplasia.

PIP: This study was conducted to assess the impact of HIV infection on the onset of rheumatic manifestations in HIV+ patients and to compare them with a control HIV- group with similar risk factors. 74 consecutive HIV+ patients were therefore studied prospectively, with researchers looking for clinical and laboratory findings of rheumatic manifestations. These cases were compared against 72 control subjects with similar risk factors for HIV who tested negative for HIV. The results suggest that rheumatic manifestations are more prevalent in HIV+ patients. Further, in advanced HIV infection, hypo and hyperuricemia may be considered markers of neoplasia. Specifically, rheumatic manifestations were found more frequently in the HIV+ group than in the HIV- group: arthralgia were found in 45%, arthritis in 10%, and Reiter's syndrome in 8%. Rheumatoid factor was found in 21% of the HIV+ group and 2% in the HIV- group, antinuclear bodies in 17% of the HIV+ group versus none in the HIV- group, and IgG anticardiolipin antibodies in 94% of the HIV+ group and 9% of the HIV- group. Hyperuricemia was observed in 31 HIV+ patients and hypouricemia in 4, compared with none in the HIV- group. Neoplasia were observed in 13 HIV+ patients. Two patients had urate abnormalities before the diagnosis and neoplasia.