Polymyositis in African HIV-infected subjects.
Polymyositis in HIV-infected subjects, clinically and pathologically resemble polymyositis in non-HIV-infected subjects. We report 14 consecutive HIV-associated polymyositis cases and compare specific features with 25 polymyositis cases seen over the same 6.5 year period. The HIV-polymyositis cases were all female and compared to the polymyositis cases were younger (median age 33 years, interquartile range (IQR) 29; 37 vs. 46 years, IQR 38; 52, p=0.002), and with 4-fold lower serum creatine kinase (CK) values (median 1158 vs. 5153IU/l; p=0.019). A definite clinical improvement on prednisone therapy was documented in eight HIV-polymyositis cases and one improved with anti-retroviral therapy alone. The recognition of HIV-polymyositis which is treatable, but may present with serum CK elevations less than twofolds above normal, is clinically relevant in sub-Saharan Africa where electromyography and muscle biopsies are not readily available.
Heckmann
J M
JM
Division of Neurology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, South Africa. jeanine.heckmann@uct.ac.za
Pillay
K
K
Hearn
A P
AP
Kenyon
C
C
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D044383:Black People; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000150:complications* / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D017285:Polymyositis / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D011241:Prednisone / Q000627:therapeutic use; D013019:South Africa; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003402:Creatine Kinase; D011241:Prednisone