The Association of Hepatitis B and Polymyositis: Rare but Real

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