Acute severe rhabdomyolysis in an human immunodeficiency virus-seropositive patient associated with rising anti-coxsackie B viral titers

Abstract

Very recently there have been sporadic reports of polymyositis in patients who are positive for human immunodeficiency virus (HIV). The cause of this condition has not been documented. Recent evidence has been presented which indicates that the Coxsackie B virus may be a causative factor. Presentation is made of a patient, a drug abuser who was found to be HIV-positive with severe polymyositis manifested by generalized muscle weakness and a total serum creatinine kinase that reached the unusually high level of > 600,000 U/L. This patient was found to have a rise in titer of Coxsackie B-4 virus antibodies. He was negative for a variety of possible infectious causes of this condition and was negative for both antinuclear antibodies (ANA) and rheumatoid factor (RF). It is concluded that a polymyositis may indeed be associated with immunosuppressed states and that Coxsackie B-4 virus may be an important causative factor.