Dermatomyositis and HIV infection: case report and review of the literature

Abstract

Since the 1980s, a host of autoimmune phenomena and rheumatologic illnesses have been linked to infection with the human immunodeficiency virus (HIV). Given the broad effects of this virus on both the humoral and cell-mediated arms of the immune system, illnesses such as polymyositis and Reiter's syndrome appear to be more prevalent in HIV-infected individuals and occur in the absence of well-described predispositions. The activities of some rheumatologic illnesses exhibit an inverse relationship with the course of HIV infection, such as rheumatoid arthritis, which becomes more quiescent with advancing disease. Dermatomyositis is a rheumatologic illness that very infrequently occurs and during our review of literature only three other cases were reported. We present the case of a Caucasian male in his mid-20s who presented with acquired immunodeficiency syndrome and subsequently developed dermatomyositis. In this review, we highlight the current relationship between HIV infection and autoimmunity, the possible ways HIV infection may foster an environment favorable for the development of dermatomyositis, and review the previously reported cases of individuals with HIV infection who developed dermatomyositis. The complex issues of how to treat individuals with HIV and dermatomyositis is also discussed.

A Case of a 14-Year-Old Girl Who Developed Dermatomyositis Associated with <italic>Mycoplasma pneumoniae</italic> Infection

“…Idiopathic inflammatory myositis is a group of diseases charac- echorovirus [8], group A beta hemolytic streptococcus [9], human immunodeficiency virus [10], etc. One study reported that epitopes derived from homologous sequences shared between human skeletal myosin and Streptococcus M5 protein can stimulate T cells from patients with active JDM and induce various cytokines [11].…”

Susac syndrome in a patient with human immunodeficiency virus infection

“…This report of coincident SS and HIV may shed light on the pathogenesis of SS, which is likely an autoimmune disease (Magro et al 2011). Interestingly, other presumed autoimmune disorders such as Guillian–Barre syndrome, polymyositis, and dermatomyositis may present early in HIV disease, and autoantibodies are frequently detected in HIV patients (Brannagan and Zhou 2003; Carroll and Holmes 2011; Rajadhyaksha et al 2012; Zandman-Goddard and Shoenfeld 2002), suggesting that these individuals, though relatively immunosuppressed, are not invulnerable to autoimmune diseases. This case should raise awareness of SS as an etiology for encephalopathy and white matter changes even in patients with comorbid HIV.…”

Coexisting TIF1γ-positive Primary Pulmonary Lymphoepithelioma-like Carcinoma and Anti-TIF1γ Antibody-positive Dermatomyositis

“…Dermatomyositis (DM) is a systemic autoimmune disease characterized by inflammation in multiple organs, most commonly in the skin and muscle (8). The cause of DM is still unclear, but several potential triggers, such as cancer (9)(10)(11)(12) and viral infection (13)(14)(15)(16), have been reported. Especially, regarding the relationship between the pathophysiology of DM and cancer, the treatment of cancer which is associated with DM sometimes leads to an improvement in the DM-related symptoms.…”