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Research Article Open access CC BY 4.0

The Association of Hepatitis B and Polymyositis: Rare but Real

Kavita Chaudhry, Gurmeet Kaur, Priyanshu Kumar

Asian Journal of Research in Infectious Diseases · pp. 1–4 · Published 13 Apr 2023

10.9734/ajrid/2023/v13i1254

Abstract

Aims: Hepatitis B virus infection is a global health concern. Although Hepatitis B virus primarily affects hepatocytes, it sometimes develops disease manifestations outside the liver and can present as full fledged proximal myopathy.  Presentation of Case: We report a 68-year-old man presenting with progressive proximal bilateral lower limb weakness for the last 14 days. The weakness was associated with pain and one episode of fever. Examination revealed 3/5 power in the shoulder and hip joint without any sensory deficit. Biochemical investigation showed elevated CPK levels (1102 IU/L) and liver enzymes (AST – 625 IU/L, ALT – 356 IU/L). HBsAg and HBeAg came out to be positive with HBV DNA of 73000 copies/mL. MRI shoulder and hip joints revealed diffuse intramuscular and myofascial edema suggesting inflammatory myositis. Muscle biopsy was suggestive of Necrotizing Autoimmune Myopathy. Discussion: Patient symptoms improved after starting IV Prednisolone and Entecavir therapy suggesting a close association between Hepatitis B infection and myopathy. Conclusion: Although Hepatitis B virus primarily affects hepatocytes, it sometimes develops disease manifestations outside the liver, such as Polymyositis. Therefore, it is imperative to screen for Viral markers in these patients.

Hepatitis B polymyositis CPK level

References (8)

  1. 1 Hepatitis B Virus Replication in Damaged Endothelial Tissues of Patients with Extrahepatic Disease [DOI]
  2. 2 A case of polymyositis associated with hepatitis B infection.
  3. 3 Polymyositis associated with hepatitis B: management with entacavir and prednisolone [DOI]
  4. 4 The association of chronic hepatitis B and myopathy [DOI]
  5. 5 Rhabdomyolysis due to Lamivudine administration in acute viral hepatitis B infection: a case report from Malaysia. [DOI]
  6. 6 Association of acute hepatitis B and acute myopathy: a case report [DOI]
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  8. 8 A Case of Polymyositis associated with Hepatitis B infection

Cited by 3

Hepatitis B Knowledge, Risk Perception, Behavioral Skills, and Infection Burden among Students and Staff at Victoria University, Kampala, Uganda

Ismail Bamidele Afolabi, Abdulmujeeb Babatunde Aremu, Joshua Mborifue · International Journal of Pathogen Research · 2024

Polymyositis concomitant with hepatitis B virus infection: Treatment challenges

A. R. Ginting, Vincent Tandiono · Narra J · 2023

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