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May 1992

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

Author Affiliations

Department of Neurology
Division of Neuropathology University of Maryland School of Medicine Baltimore, MD 21201

Arch Neurol. 1992;49(5):440. doi:10.1001/archneur.1992.00530290022003

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

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