Acute hydrocortisone myopathy in acute severe asthma.

Knox, Alan J.; Mascie‐Taylor, B H; Muers, Martin F.

doi:10.1136/thx.41.5.411

Cited by 85 publications

(19 citation statements)

References 4 publications

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“…Consequently, acute atrophy and rhabdomyolysis might have been induced in these studies. This has also been observed in patients treated acutely with massive doses ofcorticosteroids (26)(27)(28)(29)(30). Their pattern of acute generalized muscle atrophy and weakness, however, is distinctly different from the (6) 35 (6) Mean±SD.…”

Section: Discussionmentioning

confidence: 78%

Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

Dekhuijzen¹,

Gayan‐Ramirez²,

Bock³

et al. 1993

J. Clin. Invest.

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Diaphragm atrophy and weakness occur after administration of massive doses of corticosteroids for short periods. In the present study the effects of prolonged administration of moderate doses of fluorinated and nonfluorinated steroids were investigated on contractile properties and histopathology of rat diaphragm. 60 rats received saline, 1.0 mg/kg triamcinolone, or 1.25 or 5 mg/kg i.m. prednisolone daily for 4 wk. Respiratory and peripheral muscle mass increased similarly in control and both prednisolone groups, whereas triamcinolone caused severe muscle wasting. Maximal tetanic tension averaged 2.23±0.54 kg/cm2 (SD) in the control group. An increased number of diaphragmatic bundles in the 5-mg/kg prednisolone group generated maximal tetanic tensions < 2.0 kg/cm2 (P < 0.05). In addition, fatigability during the force-frequency protocol was most pronounced in this group (P < 0.05). In contrast, triamcinolone caused a prolonged half-relaxation time and a leftward shift of the force-frequency curve (P < 0.05). Histological examination of the diaphragm showed a normal pattern in the control and 1.25-mg/kg prednisolone group. Myogenic changes, however, were found in the 5-mg/kg prednisolone group and, more pronounced, in the triamcinolone group. Selective type Ilb fiber atrophy was found in the latter group, but not in the prednisolone groups. In conclusion, triamcinolone induced type IIb fiber atrophy, resulting in reduced respiratory muscle strength and a leftward shift of the forcefrequency curve. In contrast, 5 mg/kg prednisolone caused alterations in diaphragmatic contractile properties and histological changes without fiber atrophy. (J. Clin. Invest. 1993.

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Section: Discussionmentioning

confidence: 78%

Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

Dekhuijzen¹,

Gayan‐Ramirez²,

Bock³

et al. 1993

J. Clin. Invest.

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“…10,11 Several animal and clinical studies have attributed the occurrence of ACM to the use of high doses of corticosteroids in a short period of time. [13][14][15][16][17][18][19][22][23][24] Nava et al, 22 in their rat model, showed that i.v. MP 80 mg/kg/ day for 5 days could induce severe limb and respiratory muscle wasting and predominantly type IIb muscle atrophy.…”

Section: Discussionmentioning

confidence: 99%

“…In human clinical studies, high doses of steroids (up to 3 g/day) are often administered for patients in status asthmaticus or rejection after organ transplantation. 18 ACM has been reported with increased frequency, [13][14][15][16][17][18][19] in patients who have been treated with high-dose corticosteroids since its first description by MacFalane and Rosenthal 24 in 1977. ACM differs from the slowly progressive steroid myopathy described by Cushing 25 in 1932.…”

Section: Discussionmentioning

confidence: 99%

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High-dose methylprednisolone may cause myopathy in acute spinal cord injury patients

Guo²,

et al. 2004

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Study design: Prospective cohort study. Objective: Although Bracken et al have demonstrated a significant neuroprotective effect of high-dose intravenous (i.v.) methylprednisolone (MP) within 8 h post spinal cord injury (SCI), this practice has recently been challenged. We hypothesized it is possible that acute corticosteroid myopathy (ACM) may occur secondary to the MP. This pilot study was performed to test this hypothesis. Setting: University of Miami School of Medicine/Jackson Memorial Hospital, Miami VA Medical Center, FL, USA. Methods: Subjects included five nonpenetrating traumatic SCI patients, who received 24 h MP according to National Acute Spinal Cord Injury Studies (NASCIS) protocol, and three traumatic patients who suffered SCI and did not receive MP. Muscle biopsies and electromyography (EMG) were performed to determine if myopathic changes existed in these patients. Results: Muscle biopsies from the SCI patients who received 24 h of MP showed muscle damage consistent with ACM in four out of five cases. EMG studies demonstrated myopathic changes in the MP-treated patients. In the three patients who had SCI but did not receive MP, muscle biopsies were normal and EMGs did not reveal evidence of myopathy. Conclusion: Our data suggest that MP in the dose recommended by the NASCIS may cause ACM. If this is true, part of the improvement of neurological recovery showed in NASCIS may be only a recording of the natural recovery of ACM, instead of any protection that MP offers to the injured spinal cord. Sponsorship:

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“…Consequently, acute atrophy and rhabdomyolysis might have been induced in these studies. This has also been observed in patients with acute air ways obstruction, treated with massive doses of corticosteroids (8,(24)(25)(26). This pattern of acute generalized muscle atrophy and weakness, however, is distinctly different from the clinical pat tern observed during chronic steroid myopathy.…”

Section: Discussionmentioning

confidence: 74%

Recovery of corticosteroid-induced changes in contractile properties and morphology of rat diaphragm.

Dekhuijzen¹,

Gayan‐Ramirez²,

Bisschop³

et al. 1996

Am J Respir Crit Care Med

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Acute hydrocortisone myopathy in acute severe asthma.

Cited by 85 publications

References 4 publications

Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

Triamcinolone and prednisolone affect contractile properties and histopathology of rat diaphragm differently.

High-dose methylprednisolone may cause myopathy in acute spinal cord injury patients

Recovery of corticosteroid-induced changes in contractile properties and morphology of rat diaphragm.

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