title: Rheumatoid polyarthritis suspected in an HIV patient with scleritis, peripheral ulcerative keratitis, and anterior uveitis.
abstract: BACKGROUND
  Scleritis and peripheral ulcerative keratitis are ocular manifestations found in many inflammations and infections. Therefore, their association should prompt a search for inflammatory or infectious causes that may be life-threatening, especially in the context of AIDS due to HIV infection.
  
  
  RESULTS
  We report the case of a 37-year-old female, first seen in 2011 with a nodular scleritis in the right eye and a peripheral ulcerative keratitis, a necrotizing scleritis, and a granulomatous anterior uveitis in the left eye, in the context of chronic polyarthropathies that had evolved over 6 months. The patient was diagnosed with AIDS (HIV) in 2008 and was on antiretroviral therapy for the past 2 years. Ophthalmic workup was negative for opportunistic infections and potential causes of scleritis and peripheral ulcerative keratitis, and the patient was unresponsive to topical antibacterial and anti-inflammatory treatment. Ocular lesion resolution and articular swelling improvement was observed less than 6 weeks after sulfasalazine treatment. Based on American College of Rheumatology/European League Against Rheumatism classification criteria, and considering the good response to the treatment (sulfasalazine), diagnosis of rheumatoid arthritis was made in the absence of confirmatory lab tests results.
  
  
  CONCLUSIONS
  In the context of ocular manifestations associated with polyarthropathies, coexisting pathologies should be considered. Diagnostic workup of chronic inflammatory rheumatism should be carried out, even in the context of HIV/AIDS.
authors.affiliation: Université des Montagnes, Yaoundé, Cameroon.
authors.forename: Christelle
authors.initials: C
authors.lastname: Domngang Noche
authors.affiliation: Université de Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Madeleine
authors.initials: M
authors.lastname: Singwé-Ngandeu
authors.affiliation: Université de Yaoundé 1, Yaoundé, Cameroon.
authors.forename: Assumpta Lucienne
authors.initials: AL
authors.lastname: Bella
keywords: HIV/AIDS; anterior uveitis; peripheral ulcerative keratitis; rheumatoid arthritis; scleritis