Noe Myint M, Jain Akriti G, Shahid Sonia, Majeed Umair
Internal Medicine Residency, Florida Hospital, Orlando, USA.
Internal Medicine, Karachi Medical and Dental College, Karachi , PAK.
Cureus. 2018 Jul 24;10(7):e3041. doi: 10.7759/cureus.3041.
Rhabdomyolysis is characterized by muscle necrosis and leakage of toxic intracellular contents into the circulatory system. It is most commonly caused by trauma, physical exertion, drugs, toxins, and a variety of infections; only rarely is it associated with acute human immunodeficiency virus (HIV) infection alone. The severity of illness ranges from asymptomatic elevations in serum muscle enzymes to life-threatening electrolyte imbalances and acute kidney injury. High HIV viral load is associated with higher muscle breakdown that increases the incidence of severe acute kidney injury and sometimes the need for renal replacement therapy. The introduction of highly active antiretroviral therapy (HAART) revolutionized the treatment of HIV infection and increased the life expectancy of such patients by suppressing viral replication. Myopathy is one of the neuromuscular manifestations of HIV. It can occur either as a result of a complication of HIV itself or as a result of medicines used to control HIV. Muscle involvement of HIV infection ranges from asymptomatic muscle enzyme elevation to severe, HIV-associated polymyositis or pyomyositis. Here we report a case of acute retroviral syndrome presenting as severe non-traumatic rhabdomyolysis.
横纹肌溶解症的特征是肌肉坏死以及有毒的细胞内物质泄漏到循环系统中。它最常见的病因是创伤、体力消耗、药物、毒素以及各种感染；仅在极少数情况下，它单独与急性人类免疫缺陷病毒（HIV）感染相关。疾病的严重程度从血清肌肉酶无症状升高到危及生命的电解质失衡和急性肾损伤不等。高HIV病毒载量与更高的肌肉分解相关，这会增加严重急性肾损伤的发生率，有时还会增加肾脏替代治疗的需求。高效抗逆转录病毒疗法（HAART）的引入彻底改变了HIV感染的治疗方式，并通过抑制病毒复制提高了此类患者的预期寿命。肌病是HIV的神经肌肉表现之一。它既可能是HIV本身的并发症导致的，也可能是用于控制HIV的药物导致的。HIV感染的肌肉受累范围从无症状的肌肉酶升高到严重的、与HIV相关的多发性肌炎或脓性肌炎。在此，我们报告一例表现为严重非创伤性横纹肌溶解症的急性逆转录病毒综合征病例。
