HIV-Polymyositis progressing to inclusion body myositis: clues to earlier diagnosis
type: CreativeWork
description: Inflammatory myopathies in Human Immunodeficiency Virus (HIV)-positive patients may include polymyositis (PM), dermatomyositis and inclusion body myositis (IBM). Although PM is still mentioned, it is thought to be rare since the discovery of myositis autoantibodies. In the last few years it has been reported that several cases who were initially diagnosed as HIV-associated PM (HIV-PM) clinically and on muscle biopsy, change into a treatment-resistant HIV-IBM clinical phenotype. These cases are referred to as HIV-PM/IBM overlap syndrome. In recent years at Groote Schuur Hospital (GSH), we have also encountered patients with HIV-PM/IBM. Aims The aims of our study were: (1) to describe the demographic, clinical and laboratory findings in patients that were being treated for refractory “PM” and in whom the clinical diagnosis was changed from HIV-PM to HIV-IBM at the neurology unit, Groote Schuur Hospital (GSH) (2) to identify the earliest clues for this progression from HIV-PM to HIV-IBM. Methods A retrospective folder review was conducted for nine patients with HIV-IBM who interacted with the neurology service at GSH from 1 January 2000 to 30 November 2023. The duration between the diagnosis of PM and when they first satisfied the diagnostic criteria of IBM by their case notes were recorded. Results All the patients were female with a median age of 50 years at IBM diagnosis. Proximal lower limb weakness was the initial complaint of all of our patients with median age of 36 years. The median maximum CK recorded was 2500 IU/L. None of the patients had a recorded CK of more than 15 times the upper limit of normal. The median interval between symptom onset to IBM diagnosis was 11 years (range: 6-15) and the median interval between PM diagnosis and IBM diagnosis was 9 years (range: 3-14). Patients were examined after a median symptom duration of 12 years. After approximately 1.5 years of follow up, two of six patients already satisfied the ENMC 2011 clinical criteria for IB…
abstract: Inflammatory myopathies in Human Immunodeficiency Virus (HIV)-positive patients may include polymyositis (PM), dermatomyositis and inclusion body myositis (IBM). Although PM is still mentioned, it is thought to be rare since the discovery of myositis autoantibodies. In the last few years it has been reported that several cases who were initially diagnosed as HIV-associated PM (HIV-PM) clinically and on muscle biopsy, change into a treatment-resistant HIV-IBM clinical phenotype. These cases are referred to as HIV-PM/IBM overlap syndrome. In recent years at Groote Schuur Hospital (GSH), we have also encountered patients with HIV-PM/IBM. Aims The aims of our study were: (1) to describe the demographic, clinical and laboratory findings in patients that were being treated for refractory “PM” and in whom the clinical diagnosis was changed from HIV-PM to HIV-IBM at the neurology unit, Groote Schuur Hospital (GSH) (2) to identify the earliest clues for this progression from HIV-PM to HIV-IBM. Methods A retrospective folder review was conducted for nine patients with HIV-IBM who interacted with the neurology service at GSH from 1 January 2000 to 30 November 2023. The duration between the diagnosis of PM and when they first satisfied the diagnostic criteria of IBM by their case notes were recorded. Results All the patients were female with a median age of 50 years at IBM diagnosis. Proximal lower limb weakness was the initial complaint of all of our patients with median age of 36 years. The median maximum CK recorded was 2500 IU/L. None of the patients had a recorded CK of more than 15 times the upper limit of normal. The median interval between symptom onset to IBM diagnosis was 11 years (range: 6-15) and the median interval between PM diagnosis and IBM diagnosis was 9 years (range: 3-14). Patients were examined after a median symptom duration of 12 years. After approximately 1.5 years of follow up, two of six patients already satisfied the ENMC 2011 clinical criteria for IB…
author: Basant, Rai Bhuvaneshlal
keywords: Medicine
date published: 2025
date modified: 2026-07-24T01:34:03Z
provider: University of Cape Town
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Department of Medicine

PropertyValue
property ID: Handle
value: http://hdl.handle.net/11427/41508