Necrotizing myopathy in a patient with chronic hepatitis C virus infection: a case report and a review of the literature.
We describe a 61-year-old man presenting with necrotizing myopathy associated with chronic active hepatitis due to hepatitis C virus (HCV) infection. Thirteen patients with HCV-associated myopathy have been reported previously. In most of these cases, varying degrees of inflammatory changes were observed in the muscle tissue. In 2 patients, myopathy developed after initiation of interferon therapy for chronic HCV hepatitis. Our case was unusual due to long-standing elevation of creatine kinase values which improved following interferon therapy and the non-inflammatory features of the muscle tissue where the HCV RNA minus strand, a marker for replicative intermediates of the virus, was undetectable. The association of myopathy with HCV infection might represent a unique clinical entity, although the underlying pathological mechanisms remain unknown.
Satoh
J
J
Department of Internal Medicine, Saga Medical School.
Eguchi
Y
Y
Narukiyo
T
T
Mizuta
T
T
Kobayashi
O
O
Kawai
M
M
Nonaka
I
I
Kuroda
Y
Y
D001706:Biopsy; D003937:Diagnosis, Differential; D004576:Electromyography; D016174:Hepacivirus / Q000235:genetics / Q000276:immunology; D018937:Hepatitis C Antibodies / Q000032:analysis; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000175:diagnosis / Q000821:virology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology* / Q000503:physiopathology; D009135:Muscular Diseases / Q000175:diagnosis / Q000209:etiology*; D009336:Necrosis; D012367:RNA, Viral / Q000032:analysis; D020133:Reverse Transcriptase Polymerase Chain Reaction
D018937:Hepatitis C Antibodies; D012367:RNA, Viral