ACUTE SEVERE RHABDOMYOLYSIS IN AN HUMAN-IMMUNODEFICIENCY-VIRUS SEROPOSITIVE PATIENT ASSOCIATED WITH RISING ANTI-COXSACKIE-B VIRAL TITERS

Very recently there have been sporadic reports of polymyositis in pati ents who are positive for human immunodeficiency virus (HIV). The caus e of this condition has not been documented. Recent evidence has been presented which indicates that the Coxsackie B virus may be a causativ e factor. Presentation is made of a patient, a drug abuser who was fou nd to be HIV-positive with severe polymyositis manifested by generaliz ed muscle weakness and a total serum creatine 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 nega tive for both antinuclear antibodies (ANA) and rheumatoid factor (RF). It is concluded that a polymyositis may indeed be associated with imm unosuppressed states and that Coxsackie B-4 virus may be an important causative factor.