SLE and HIV infection, two systemic conditions that can be clinically indistinguishable

Systemic lupus erythematosus (SLE), the prototypic auto-immune disease, commonly affects Black patients. This connective tissue disease may involve the lymphoid organs, kidneys, skin, lungs and the central nervous system. The same organs are involved in HIV disease. We report on a patient who fulfilled both the American Rheumatism Association (ARA) (1982) criteria for the diagnosis of SLE and WHO (Bangui) clinical criteria for the diagnosis of AIDS in Africa. The patient had no laboratory evidence of HIV infection. The pitfalls associated with reliance on cheap guidelines are discussed in the context of the resources required for the effective differentiation of the disparate systemic conditions.