Dermatomyositis: a rare presentation of HIV seroconversion illness

Area of Science:

• Immunology
• Infectious Diseases
• Neurology

Background:

• Dermatomyositis is a rare autoimmune inflammatory myopathy.
• Human Immunodeficiency Virus (HIV) infection is rarely associated with dermatomyositis.
• Only four cases of HIV with subsequent dermatomyositis have been documented.

Observation:

• This report details the first case of dermatomyositis presenting as the initial manifestation of acute HIV seroconversion illness.
• A 50-year-old woman presented with proximal muscle weakness and classic dermatomyositis signs, confirmed by electromyography and muscle biopsy.
• Initial HIV tests were nonreactive, becoming positive after 8 weeks, confirmed by Western blot and PCR.

Findings:

• Dermatomyositis can be an initial presentation of acute HIV infection.
• Diagnosis requires a high index of suspicion for HIV seroconversion in patients with dermatomyositis.
• Successful treatment involves a careful balance of immunosuppressive therapy (prednisolone) and antiretroviral therapy.

Implications:

• This case expands the understanding of dermatomyositis as a potential early indicator of HIV infection.
• It underscores the importance of considering HIV in the differential diagnosis of unexplained dermatomyositis.
• Effective management necessitates a nuanced approach to combined immunosuppressive and antiviral treatments.