Yeh T S, Wang C R, Huang S H, Huang S F, Yang P C, Chuang C Y
Department of Internal Medicine, National Taiwan University Hospital, Taipei, R.O.C.
J Formos Med Assoc. 1993 Feb;92(2):192-4.
Neuromuscular manifestations, including a variety of peripheral neuropathies and myopathies, can occur either as isolated clinical phenomena or concurrently with other clinical manifestations, and are common in acquired immunodeficiency syndrome (AIDS). A 33-year-old male patient had a four-year history of increasing proximal muscle weakness of the extremities. Elevated muscle enzymes, a muscle biopsy and interstitial lung disease all suggested a diagnosis of polymyositis with lung involvement. However, a transbronchial lung biopsy revealed Pneumocystis carinii pneumonia, and serology for HIV infection disclosed positive results. Zidovudine and cotrimoxazole were instituted and the patient improved. HIV-associated myopathy should be considered by practicing clinicians in cases presenting with myopathy, since the number of patients with HIV infection is increasing in Taiwan.
神经肌肉表现,包括各种周围神经病变和肌病,可作为孤立的临床现象出现,或与其他临床表现同时出现,在获得性免疫缺陷综合征(AIDS)中很常见。一名33岁男性患者有四年四肢近端肌肉无力逐渐加重的病史。肌酶升高、肌肉活检和间质性肺病均提示诊断为伴有肺部受累的多发性肌炎。然而,经支气管肺活检显示卡氏肺孢子虫肺炎,HIV感染血清学检测结果呈阳性。给予齐多夫定和复方新诺明治疗后患者病情好转。鉴于台湾地区HIV感染患者数量不断增加,临床医生在遇到肌病病例时应考虑HIV相关肌病。