Multicentric reticulohistiocytosis: case report with response to infliximab and review of treatment options.

Multicentric reticulohistiocytosis (MRH) is a rare systemic and devastating disease with main involvement of skin and joints, frequently related with malignancies. Macrophages and TNFα are the main targets of multiple treatment options with variable results. Although MRH has the tendency of self-resolve in an average of 8 years, treatment must be started early to avoid sequelae, mainly in joints with severe deformities and daily life activity impairment. We describe a 50-year-old man with skin and joint involvement, with a non-previously described muscle affectation, that failed to different drugs and achieved skin improvement with infliximab. We review for the first time in medical literature the available therapeutic options of MRH and its outcomes and propose possible future targets.

Vertebral osteonecrosis in an HIV-infected patient.

Vertebral osteonecrosis, also known as Kümmell's disease, is a disorder resulting in non-consolidation of a vertebral fracture caused by ischaemia. The main differential diagnosis of vertebral osteonecrosis is osteoporotic vertebral fracture; however, the former is associated more frequently with severe pain and neurological complications. Although HIV-infected patients have an increased risk of developing osteonecrosis in peripheral locations and osteoporotic vertebral fractures, the occurrence of vertebral osteonecrosis has not been previously reported in any of the large series of HIV-associated osteonecrosis. Here, we report an HIV-infected patient who developed vertebral osteonecrosis with refractory pain and displayed rapid kyphotic deformity development during HAART.