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Progressive Nemaline (Rod) Myopathy as a Presentation of Human Immunodeficiency Virus Infection

Boyd A. Dwyer, MD; Richard F. Mayer, MD; Sunhee C. Lee
Arch Neurol. 1992;49(5):440-440. doi:10.1001/archneur.1992.00530290022003
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To the Editor.  —Nemaline (rod) myopathy associated with human immunodeficiency virus (HIV) infection has been reported in male patients at risk for the infection.1,2

Report of a Case.  —We report the case of a 23-year-old woman who presented with a 6-month history of progressive weakness. Neuromuscular examination showed marked proximal muscle weakness and an exaggerated lordotic posture. An electromyogram was mildly abnormal, the serum creatine kinase concentration was borderline elevated, metabolic study results were normal, and family history was negative. A deltoid muscle biopsy specimen revealed prominent random atrophic myofibers containing numerous intracytoplasmic rod bodies, especially in type 1 fibers. No inflammatory response was present. Electron microscopy revealed the bodies to be electron-dense filamentous accumulations that had a crystalline periodicity on cross-section characteristic of nemaline rods. No viral particles were noted. A serum HIV titer drawn at the time of the biopsy was positive by enzyme-linked immunosorbent assay and

REFERENCES

Gonzales MF, Olney RK, So YT, et al.  Subacute structural myopathy associated with human immunodeficiency virus infection . Arch Neurol . 1988;;45:585-587.
Simpson DM, Bender AN.  Human immunodeficiency virus-associated myopathy: analysis of 11 patients . Ann Neurol . 1988;;24:79-84.

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Gonzales MF, Olney RK, So YT, et al.  Subacute structural myopathy associated with human immunodeficiency virus infection . Arch Neurol . 1988;;45:585-587.
Simpson DM, Bender AN.  Human immunodeficiency virus-associated myopathy: analysis of 11 patients . Ann Neurol . 1988;;24:79-84.

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