title: Destructive spondyloarthropathy in a haemodialysis patient with HIV infection: case report and literature review.
abstract: This case describes the presentation, diagnosis and treatment of a 59-year-old man with medical history of HIV/AIDS and hepatitis C on haemodialysis for end stage renal disease who presented with debilitating neck pain radiating down to the left arm with associated weakness of left upper and lower extremities. He had received a prolonged course of intravenous antibiotics for similar complaints. His initial presentation, coupled with the history of recent antibiotics, triggered a non-infectious work-up and the patient was diagnosed with destructive spondyloarthropathy, a rare but under-diagnosed complication of patients on long-term haemodialysis. This was confirmed on imaging studies. The patient refused surgical intervention, and was treated conservatively. With improved survival of patients with HIV infection, other significant co-morbidities like end stage renal disease and their potential complications in these patients have become an increasing focus of attention. Destructive spondyloarthropathy is a severely debilitating condition and can be potentially fatal. The aetiopathogenesis, management and ethical and legal implications of HIV patients with destructive spondyloarthropathy secondary to long-term haemodialysis are discussed.
authors: Department of Medicine.
authors: V
authors: V
authors: Agarwal
authors: V
authors: V
authors: Gandhi
mesh_terms: D015658:HIV Infections / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D019547:Neck Pain / Q000209:etiology; D006435:Renal Dialysis / Q000009:adverse effects*; D025242:Spondylarthropathies / Q000000981:diagnostic imaging / Q000209:etiology*; D014057:Tomography, X-Ray Computed
keywords: AIDS; HIV; destructive spondyloarthropathy; end stage renal disease; haemodialysis