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Polymyositis masquerading as mitochondrial toxicity
  1. K P Prime1,
  2. S G Edwards1,
  3. M R Pakianathan1,
  4. J L Holton2,
  5. F Scaravilli2,
  6. R F Miller3
  1. 1Department of Genitourinary Medicine, Camden Primary Care Trust, Mortimer Market Centre, London WC1E 6AU, UK
  2. 2Department of Molecular Pathogenesis, Division of Neuropathology, Institute of Neurology, University College London, London WC1N 3BG, UK
  3. 3Department of Sexually Transmitted Diseases, Royal Free and University College Medical School, University College London and Camden Primary Care Trust, Mortimer Market Centre, London WC1E 6AU
  1. Correspondence to:
 Dr K P Prime, Department of Genitourinary Medicine, Camden Primary Care Trust, Mortimer Market Centre, London WC1E 6AU, UK; 
 katiaprime{at}hotmail.com

Abstract

A 66 year old HIV infected male heavy smoker presented with arthralgia, myalgia, and weight loss which was originally ascribed to nucleoside induced mitochondrial toxicity. Despite withdrawal of antiretroviral therapy a proximal myopathy developed. Further investigation excluded malignancy. Polymyositis was diagnosed on muscle biopsy. The patient recovered completely with oral prednisolone. This case highlights the importance of muscle biopsy in HIV infected patients whose myopathy persists despite withdrawal of antiretroviral therapy and the need for thorough investigation of non-specific symptoms in HIV infected patients who are receiving antiretroviral therapy.

  • HIV
  • polymyositis
  • myopathy
  • muscle biopsy
  • mitochondrial toxicity

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Footnotes

  • Source of income: nil.

  • Conflict of interest: none declared.