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• Vol.44 No.9
• CLINICA NEUROL, 44: 609−614, 2004
• Vol.44 No.9 contents

Case Report

Inclusion body myositis after interferon-α treatment in a patient with HCV and HTLV-1 infection

Yoko Warabi, M.D.¹⁾, Shiro Matsubara, M.D.¹⁾, Toshio Mizutani, M.D.²⁾ and Hideaki Hayashi, M.D.¹⁾

¹⁾Department of Neurology and ²⁾Neuropathology, Tokyo Metropolitan Neurological Hospital

We report the first case of inclusion body myositis (IBM) which occurred after interferon-α treatment for chronic hepatitis C. A 63-year-old man contracted hepatitis C virus (HCV) and human T cell leukemia virus type 1 (HTLV-1) from a blood transfusion at age of 18. At age 57, he was treated with interferon-α (IFN α) for chronic hepatitis C. A month later, he developed muscle weakness in the proximal part of his lower extremities. IBM was diagnosed after a muscle biopsy at age 62. Steroid therapy improved his muscle power. One year later, worsening of his hepatic condition required re-administration of IFN α after gradual decrease and discontinuation of prednisolone. However, several days later, he rapidly became weaker and required a cane to walk. Elevated serum creatine kinase (2,199 IU/L) and abnormal intensity in his MRI of thigh were demonstrated. The second muscle biopsy, performed after obtaining the informed consent from our patient, confirmed relapse of IBM. His symptoms improved again after discontinuation of IFN α and re-induction of prednisolone.
Although a few cases each of IBM associated with HCV or HTLV-1 have been reported, the pathogenesis of virus-associated inflammatory myositis has not been clearly understood. Moreover, there has been no description on IBM associated with IFN α treatment, though several cases of polymyositis have been reported. Our case suggests that infection of HCV and HTLV-1 may be immunologically involved in the development of IBM and that IFN α can be directly related to onset and relapse of IBM.

(CLINICA NEUROL, 44: 609−614, 2004)
key words: inclusion body myositis (IBM), hepatitis C virus (HCV), human T cell leukemia virus type 1 (HTLV-1), interferon-α (IFN α)

(Received: 6-Jan-04)