Acute arthritis and human immunodeficiency virus infection in Rwanda.

Objective: To determine the etiology of acute arthritis observed in adults and to define its relationship with human immunodeficiency virus 1 (HIV-1) infection in Kigali, capital city of Rwanda.

Methods: From September 1, 1989 until March 31, 1990 we conducted a study of all new patients admitted with acute arthritis to the outpatient and inpatient services of the Department of Internal Medicine at the Centre Hospitalier de Kigali, in Kigali, Rwanda, a city highly endemic for HIV infection.

Results: Thirty-six patients (27 men 9 women; mean age: 31 years, range 18-65) were included in the study.

[Inflammatory Gorham disease].

The case of a 48-year old female with massive osteolysis since the age of 13 years is reported. She had inflammatory flares which resolved spontaneously or after a transient discharge of lymph.

[Osteoporosis during pregnancy. 4 cases].

Osteoporosis of pregnancy is an infrequent condition of unclear pathogenesis. We report four new cases. Mean age of patients was 28 years; diffuse bone loss was seen on pre-pregnancy roentgenograms in two patients.

[Arthritis in HIV infection. A prospective study of 76 cases in Rwanda].

A 16-month prospective study of adult patients who had been suffering from arthritis for less than one year was conducted in the Internal Medicine department of the hospital of Kigali, Rwanda. Seventy-six patients were included in the study. Out of 72 patients whose sera were tested for human immunodeficiency virus (HIV), 52 were positive, this being 72.

[Methotrexate in dermatology: current aspects].

The prescription of methotrexate (MTX) in dermatology is nowadays restricted for two main reasons: the toxicity of the drug and the availability of less toxic treatments (phototherapy and etretinate) in its main indication: psoriasis. However, MTX remains very useful in severe psoriasis, to some extent, in various dermatological diseases, such as dermatomyositis. A perfect knowledge of its adverse effects (slight on the gastrointestinal tract and bone marrow, much more serious on the liver and lung) allows a reasonable use of the drug but cannot avoid the unpredictable hypersensitivity pneumopathy.