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Query: UMLS:C0021051 (immunodeficiency)
 71,517 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Neuromuscular diseases are common in acquired immune deficiency syndrome (AIDS). Although the clinical incidence of peripheral neuropathy has not been systematically studied, various reports suggest that up to 40% of AIDS patients have clinical symptoms. Biopsy and autopsy studies have shown an inflammatory neuropathy with a variable component of demyelination and axonal loss. Evidence of direct involvement by the human immunodeficiency virus (HIV) is scant. Immunosuppression followed by cytomegalovirus (CMV) infection appears to be a direct cause of polyradiculoneuropathy and perhaps other forms of peripheral neuropathy in AIDS. The clinical incidence of myopathy in AIDS is less clear, and clinically less appreciated than the neuropathy. Scattered reports have identified an inflammatory myopathy that does not appear to be due to direct HIV infection, but could be mediated by another human retrovirus. HIV seropositive patients being treated with antiviral drugs develop a unique set of neuromuscular diseases that must be distinguished from the non-drug-related conditions.
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PMID:Neuromuscular diseases of AIDS. 255 21

A patient with acquired immune deficiency syndrome (AIDS) developed a progressive neuromuscular disorder which included a sensory component, severe weakness and muscle wasting, and fasciculations. At autopsy, there was evidence of severe peripheral neuropathy, as well as widespread cytomegalovirus (CMV) infection within the central and peripheral nervous system. Although the anterior horn cell complement within the spinal cord appeared normal, there was also evidence of human immunodeficiency virus (HIV)-like immunoreactivity of rare anterior horn cells, as judged by immunohistochemical staining. This patient illustrates the complexity of pathogenetic mechanisms operative in AIDS patients with neuromuscular disease, and suggests that at least some examples of neuromuscular disease in patients with this syndrome may be related to widespread CMV infection of the peripheral nerve (including microvascular endothelial cells) and, more rarely, direct HIV infection of some anterior horn cells.
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PMID:Severe neuropathy in a patient with acquired immune deficiency syndrome (AIDS). Evidence for widespread cytomegalovirus infection of peripheral nerve and human immunodeficiency virus-like immunoreactivity of anterior horn cells. 255 84

Neuromuscular disorders are increasingly being reported in individuals with human immunodeficiency virus (HIV) infection. The majority of these disorders resemble diseases occurring in HIV-seronegative patients and include inflammatory demyelinating polyneuropathies, multiple mononeuropathies, and polymyositis. In HIV-seronegative patients, these diseases are believed to be immune system-mediated. It is likely that similar pathogenic mechanisms are present in HIV-seropositive patients and reflect an altered immune system caused by viral infection and the loss of CD4 cells. Therapy is similar in both seropositive and seronegative patients with inflammatory demyelinating polyneuropathies, but plasmapheresis is preferred in seropositive patients as it is less likely than corticosteroids to induce further immunosuppression. Distal sensory neuropathy is characteristic in patients infected with HIV, especially those with the acquired immunodeficiency syndrome (AIDS) or AIDS-related complex, and may be a consequence of HIV infection. Therefore, antiviral agents may have a therapeutic role for this disorder.
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PMID:Treatment of the neuromuscular complications of human immunodeficiency virus infection. 283 7

Neuromuscular disorders reported in association with human immunodeficiency virus (HIV) infection include several forms of peripheral neuropathy and polymyositis. We report 11 patients with HIV-associated myopathy. Five patients with acquired immunodeficiency syndrome (AIDS), 2 with AIDS-related complex, and 4 otherwise asymptomatic HIV-infected patients developed progressive proximal muscle weakness. Serum creatine phosphokinase levels were elevated and electromyography revealed abnormal spontaneous activity and myopathy in most patients. All 8 muscle biopsy specimens showed fiber necrosis. Four had inflammatory infiltrates, and nemaline rod bodies were prominent in 3. Immunosuppressant therapy in 5 patients resulted in improvement. Attempts at viral localization in 4 muscle biopsy specimens were unsuccessful. These findings suggest a distinct association between HIV infection and myopathy with features atypical for polymyositis.
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PMID:Human immunodeficiency virus-associated myopathy: analysis of 11 patients. 284 80

Neuromuscular diseases occur in as many as 50% of patients infected with human immunodeficiency virus type 1 (HIV-1). All forms of neuromuscular disease have been reported, including axonal neuropathy, demyelinating neuropathy, mononeuropathy multiplex, polyradiculitis, ALS-like syndromes, disorders of neuromuscular transmission, myopathy, and toxic neuropathies due to medication side effects. Neuromuscular disease is often the presenting manifestation of HIV-1 infection. Infection with cytomegalovirus (CMV) is associated with different types of neuropathy including mononeuritis multiplex and polyradiculopathy. There is effective treatment for many of the associated disorders including chronic inflammatory demyelinating neuropathy, CMV-mediated neuropathies, and myopathy. Treatment of CMV-mediated mononeuropathy multiplex may be life saving. The different neuromuscular syndromes associated with different stages of HIV-1 infection may be due, in part, to different levels of immunocompetence.
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PMID:AAEM minimonograph #41: neuromuscular diseases associated with HIV-1 infection. 826 98

Neuromuscular disorders are the most frequent neurologic complications associated with human immunodeficiency virus (HIV) infection and AIDS. Although neurologic disorders are frequently overlooked, they add considerable morbidity and mortality to patients with HIV infection. It is critically important to properly diagnose and treat these neuromuscular complications, which leads to substantial improvement in patients' quality of life. Distal symmetric polyneuropathy is the most common form of peripheral neuropathy in HIV infection. It occurs mainly in patients with advanced immunosuppression and may also result from the neurotoxicity of several antiretroviral agents. Myopathy may occur at any stage of HIV disease and has also been described as a toxic side effect of zidovudine. Here we review the clinical features, diagnostic approach, and pathogenetic mechanisms of the neuromuscular complications of HIV infection. We also discuss management strategies and the results of clinical trials for the treatment of these disorders.
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PMID:Neuromuscular complications of the human immunodeficiency virus type 1 infection. 1071 36

Neuromuscular disorders are common in human immunodeficiency virus (HIV); they occur at all stages of disease and affect all parts of the peripheral nervous system. These disorders have diverse etiologies including HIV itself, immune suppression and dysregulation, comorbid illnesses and infections, and side effects of medications. In this article, we review the following HIV-associated conditions: distal symmetric polyneuropathy; inflammatory demyelinating polyneuropathy; mononeuropathy; mononeuropathy multiplex; autonomic neuropathy; progressive polyradiculopathy due to cytomegalovirus; herpes zoster; myopathy; and other, rarer disorders.
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PMID:Neuromuscular diseases associated with HIV-1 infection. 1977 94

Prominent neck extension weakness is an uncommon clinical entity, also termed dropped-head syndrome, that may be part of a generalized neuromuscular disorder. We report here the case of a woman with dropped-head syndrome and pulmonary arterial hypertension secondary to systemic sclerosis. Subsequently, she developed common variable immunodeficiency and subcutaneous immunoglobulin therapy was started. After two months from the start of therapy we did not observe any improvement in the degree of flexion of the head, although the clinical examination shows an improvement in neck extensor muscle strength. Subcutaneous immunoglobulin therapy could be a possible therapeutic option for the treatment of myopathic neck extensor weakness.
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PMID:Subcutaneous immunoglobulin therapy in a patient with myopathic dropped head syndrome and common variable immunodeficiency. 2221 99