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Related Experiment Videos

Polymyositis masquerading as mitochondrial toxicity.

K P Prime1, S G Edwards, M R Pakianathan

  • 1Department of Genitourinary Medicine, Camden Primary Care Trust, Mortimer Market Centre, London WC1E 6AU, UK. katiaprime@hotmail.com

Sexually Transmitted Infections
|October 24, 2003
PubMed
Summary
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This case study shows that persistent myopathy in HIV patients requires further investigation beyond antiretroviral toxicity. Muscle biopsy is crucial for diagnosing polymyositis and guiding effective treatment with corticosteroids.

Area of Science:

  • Infectious Diseases
  • Neurology
  • Rheumatology

Background:

  • Antiretroviral therapy (ART) is standard for Human Immunodeficiency Virus (HIV) management.
  • Nucleoside reverse-transcriptase inhibitors (NRTIs) used in ART can cause mitochondrial toxicity, presenting as myopathy.
  • Non-specific symptoms like arthralgia, myalgia, and weight loss are common in HIV patients on ART.

Observation:

  • A 66-year-old male, HIV-positive and heavy smoker, presented with arthralgia, myalgia, and weight loss.
  • Initial symptoms were attributed to NRTI-induced mitochondrial toxicity.
  • Proximal myopathy developed despite ART withdrawal, prompting further investigation.

Findings:

  • Malignancy was excluded through comprehensive workup.
  • Muscle biopsy confirmed polymyositis as the diagnosis.

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  • The patient achieved complete recovery with oral prednisolone treatment.

    • Implications:

    • Persistent myopathy in HIV patients, even after ART cessation, necessitates thorough investigation.
    • Muscle biopsy is a critical diagnostic tool for differentiating causes of myopathy in HIV.
    • Early diagnosis and appropriate treatment, such as corticosteroids for polymyositis, improve patient outcomes.