P21.11 Muscle weakness and atrophy as initial symptoms of acquired immunodeficiency syndrome (AIDS): A case report

Abstract

We analyzed a rare case of unexplained progressive generalized muscle weakness and muscle atrophy. The patient had experienced weakness in both the lower limbs 5 months prior, which gradually progressed to muscle atrophy. From the time of disease onset, he lost 6 kg body weight. Ten years prior, he had undergone blood transfusions and was involved in risky sexual behavior. During the physical examination, the patient lay supine. Multiple tattoos were found on his body. The muscle strength of the neck and proximal extremities was at level II, and that of the distal extremities was at level IV. The patient showed general muscle atrophy but displayed eugnosia. Tendon reflexes were diminished, without any pathological signs. Electromyogram (EMG) revealed myogenic damage. Blood tests showed mildly elevated creatine kinase (CK) levels and a normal erythrocyte sedimentation rate (ESR). The patient tested positive for human immunodeficiency virus (HIV), showing that this was a case of acquired immunodeficiency syndrome (AIDS)-related myopathy. Anti-AIDS treatment halted the progression of his symptoms. The patient died at home due to acute cardiac arrest 5 years after disease onset, but the actual cause of death was not clear. Our results suggest that in patients with unexplained myopathy, the possibility of AIDS-related myopathy should be considered.