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M94A2935.TXT
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1994-10-25
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Document 2935
DOCN M94A2935
TI Acute paralysis of the serratus muscle in an HIV positive patient
treated by DDC.
DT 9412
AU Faller JP; Ziegler F; Balblanc JC; Labouret P; Ruyer O; Centre
Hospitalier, Belfort, France.
SO Int Conf AIDS. 1994 Aug 7-12;10(1):191 (abstract no. PB0193). Unique
Identifier : AIDSLINE ICA10/94369640
AB OBJECT: to document paralysis of the serratus muscle as a manifestation
of HIV infection in AIDS with no other neuropathical manifestations. A
35 years old HIV infected man (risk factor: homosexual, stage II B, CD4
cell count: 192) had been on DDC therapy for 2 months when he was
evaluated for a one week history of acute pain in the right scapula,
occurring more frequently at night. The diagnosis of complete paralysis
was clear, due to the typical signs of excessive adduction of the
scapula edge with the foward movement of the arm (picture 1). No sensory
disturbance was reported and examination revealed hyporeflexia biceps
jerk. Our nerve conducted study on day 15 revealed a small neurogenic
atrophia with no increase in distal latency. The second study on day 45
revealed no spontaneous dernervation and suggested C6 radiculoneuritis.
The patient refused lumbar puncture. There was no evidence in particular
of cytomegalovirus, Herpes Simplex Virus, Epstein Barr Virus. An MRI
showed no herniated disk. Despite continued DDC treatment, a marked
clinical improvement was observed. Functional recovery was almost
complete in 3 months time. DISCUSSION AND CONCLUSION: our case differs
from the traditional description of this type of paralysis precisely
because of the absence of Havresac syndrome, Parsonage-Tuner syndrome, a
herniated disk or vaccination in this area. There was improvement
despite therapy. Our results suggest the possible implication of the HIV
virus, another infection, or autoimmune mechanism. No such cases have
previously been reported in HIV patients to our knowledge. We are
therefore alerting clinicians that there may be a link between HIV
infection and this type of this neuropathical manifestation.
DE Adult Follow-Up Studies Human HIV Seropositivity/*DIAGNOSIS/DRUG
THERAPY Male Muscles/INNERVATION Muscular Atrophy/DIAGNOSIS/DRUG
THERAPY Neurologic Examination/DRUG EFFECTS Paralysis/*DIAGNOSIS/DRUG
THERAPY Radiculitis/*DIAGNOSIS/DRUG THERAPY Scapula/*INNERVATION
Zalcitabine/THERAPEUTIC USE MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).