1 5 2 Sondheimer et at. The Journal of Pediatrics July I991 2. Goldman J, Reicheldefer M. Evaluation of rapid colonoscopy using a new gut lavage solution. Gastrointest Endosc 1982;28: 9-1l. 3. Ernstoff J J, Howard DA, Marshall JB, Jumshyd A, McCul- lough AJ. A randomized blinded clinical trial of a rapid colonic lavage solution (Golytely) compared with standard prepara- tion for colonoseopy and barium enema. Gastroenterology 1983;83:1512-6. 4. Fordtran JS, SantaAna CA, Cleveland MB. A low sodium so- lution for gastrointestinal lavage. Gastroenterology 1990; 98:11-6. 5. Brady CE, DiPalma JA, Morawski SG, SantaAna CA, Ford- tran JS. Urinary excretion of polyethylene glycol-3350 and sulfate after gut lavage with a polyethylene glycol electrolyte lavage solution. Gastroenterology 1986;90:1914-8. 6. Cleghorn G J, Stringer DA, Forstner GG, Durie P. Treat- ment of distal intestinal obstruction syndrome in cystic fibro- sis with a balanced intestinal lavage solution. Lancet 1986;1: 8-ll. 7. Koletzko S, Stringer DA, Cleghorn G J, Durie PR. Lavage treatment of distal intestinal obstruction syndrome in children with cystic fibrosis. Pediatrics 1989;83:727-33. 8. Tenenbein M. Whole bowel irrigation in iron poisoning. J PE- DIATR 1987;111 : 142-5. 9. Postuma R. Whole bowel irrigation in pediatric patients. J Pe- diatr Surg I988;23:769-70. 10. Tolia V, Fleming S, Dubois R. Use of Golytely in children and adolescents. J Pediatr Gastroenterol Nutr I984;3:468-70. II. Tuggte DW, Perkins TA, Tunnell WP. Outpatient bowel preparation for children. J Pediatr Surg 1989;24:703-4. 12. Ingebo KB, Heyman MB. Polyethylene glycol-electrolyte so- lution for intestinal clearance in children with refractory encopresis: a safe and effective therapeutic program. Am J Dis Child 1988;142:340-2. Clinical and laboratory observations Myopathy in human immunodeficiency virus-infected children receiving long-term zidovudine therapy Emmanuel B. Walter, MD, Robert P. Drucker, MD, Ross E. McKinney, MD, and Catherine M. Wilfert, MD From the Department of Pediatrics, Duke University Medical Center, Durham, North Carolina Before the widespread use of antiretroviral agents, myopa- thy was reported as an infrequent manifestation of human immunodeficiency virus infection in adults.l4 Since the in- troduction of zidovudine as a therapeutic agent in the treatment of HIV infection, there have been an increasing number of reports of myopathy in adults. 57 Elevations in creatine kinase activity have been noted in as many as 15% Supported in part by the AIDS Clinical Trials Group, National Institute of Allergy and Infectious Diseases, and in part (Dr. Wal- ter) by the American Foundation for AIDS Research (Pediatric AIDS Scholar). Submitted for publication Dec. l i, 1990; accepted Feb. 12, 1991. Reprint requests: Emmanuel Walter, MD, Box 31273, Duke Uni- versity Medical Center, Durham, NC 27710. 9/26/28744 of adults treated with zidovudine, s There have been no re- ports of myopathy associated with HIV infection in a child. We are reporting a case of a child with acquired immuno- deficiency syndrome who had a markedly elevated CK level while receiving long-term zidovudine therapy. We also de- scribe the CK determinations in 87 children with symp- tomatic HIV infection who were being treated with zido- vudine. CK Creatine kinase HIV Human immunodeficiency virus CASE REPORT A 38-month-old black girl with vertically acquired H1V infection and acquired immunodeficiency syndrome came to the infectious disease clinic because of a 3-day history of fever and rash. Two weeks before admission she had cellulitis of the right hand and was