Abstract
A 35 year old homosexual man showed clinical features of myopathy, with progressive muscular weakness of proximal muscles. EMG demonstrated a myopathic pattern; serum CPK was mildly elevated and CSF examination revealed antibodies to HIV and a blood-brain barrier damage.
An open biopsy of the quadriceps femoris muscle showed myopathic changes with inflammatory features including a marked variation in fiber size, necrotic fibers and phagocytosis, a profusion of internal nuclei. Fiber type analysis with myosin ATPase reaction revealed that myopathic changes involved both fiber types. Changes in the oxidative enzyme activities were also observed in the degenerating muscle fibers. Electron microscopy showed patterns of myofibrillar degeneration and characteristic rod bodies in 30% of fibers.
The close resemblance of the present morphological results with those recently observed in some HIV antibody positive men seems to indicate the existence of a specific structural myopathy associated with AIDS.
Sommario
Gli AA riportano il caso di un soggetto di 35 anni omosessuale con una debolezza muscolare progressiva prossimale ai 4 arti ad impronta miopatica.
L’EMG era di tipo miogeno; il CPK era lievemente aumentato; l’esame del liquor evidenziava un danno di barriera e positività degli anticorpi HIV.
La biopsia muscolare evidenziava un quadro miopatico, con aspetti infiammatori, che comprendeva: marcata variabilità del diametro delle fibre, fibre necrotiche e fagocitosi, nuclei interni ed infiltrati linfo-istiocitari.
Lo studio istochimico e istoenzimatico evidenziava compromissione di entrambi i tipi di fibre con modificazione delle attività ossidative nelle fibre in degenerazione. La microscopia elettronica mostrava un quadro di degenerazione miofibrillare con la presenza di caratteristici “rod bodies” nel 30% delle fibre. La stretta bra indicare l’esistenza di una specifica miopatia strutturale associata con l’AIDS.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bailey R.O., Turok D.I., Jaufmann B.P., Sing J.K.:Myositis and acquired immunodeficiency syndrome. Hum. Path., 18:749–751, 1987.
Berger J.R., Moskowitz L., Fische M., Kelley R.E.:The neurologic complications of AIDS; frequently the initial manifestation. Neurology, 34:134–135, 1984.
Comi G., Medaglini S., Galardi G.:Subclinical muscular involvement in acquired immune deficiency syndrome. Muscle and Nerve, 9:665, 1986.
Dalakas M.C.:Neuromuscular complications in acquired immune deficiency syndrome. Muscle and Nerve, 9:92, 1986.
Dalakas M.C., Pezeshkpour G.H., Gravell M., Sever J.L.:Polymyositis associated with AIDS retrovirus. JAMA 256:2381–2383, 1986.
Dalakas M.C., Pezeshkpour G.H.:Neuromuscular diseases associated with human immunodeficiency virus infection. Ann. Neurol., 23:538–548, 1988.
Gonzales M.F., Olney R.K., So Y.T., Greco C.M., McQuinn B.A., Miller R.G., DeArmond S.J.:Acute structural myopathy associated with human immunodeficiency virus infection. Arch. neurol., 45:585–587, 1988.
Levy R.M., Bredesen D.E., Rosenblum M.L.:Neurological manifestations of the acquired immune deficiency syndrome (AIDS): experience at UCSF and review of the literature. J. Neurosurgery, 62:475–495, 1985.
Snider W.D., Simpson D.M., Nielsen S., Gold J.W.M., Metroka C.E., Posner J.B.:Neurological complications of acquired immune deficiency syndrome: analysis of 50 patients. Ann. Neurol., 14:403–418, 1989.
Stern R., Gold J., Di Carlo E.F.:Myopathy complicating the acquired immune deficiency syndrome. Muscle and Nerve, 10:318–322, 1987.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Scelsi, R., Lombardi, M., Banfi, P. et al. Acquired rod-body myopathy associated with human immunodeficiency virus infection. Ital J Neuro Sci 11, 609–613 (1990). https://doi.org/10.1007/BF02337447
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02337447