Respiratory muscles in endocrinopathies

Abstract

The aim of this review was to demonstrate that RM function is altered in various endocrinopathies and that RM weakness is a common finding. RM function has been well-studied in diseases such as thyroid dysfunction, and steroid induced RM myopathies. Less well documented reports on RM function were found in parathyroid dysfunctions, disorders of mineralocorticoids and pituitary disturbances. Controversial reports were found in diabetes mellitus. No report was found connecting RM function with androgens, pheochromocytoma or adrenaline deficiency in humans. These diseases could potentially cause RM impairment leading to severe respiratory failure (pump failure) putting life in great danger. Therefore, it is obvious that further studies are needed to investigate the performance of RMs in endocrinopathies. Such studies are extremely urgent in Cushing's and Addison's disease, acromegaly, disorders of the adrenal medulla, and in diabetes insipidus.

Prolonged Dyspnea after Interscalene Block: Attributed to Undiagnosed Addison's Disease and Myasthenia Gravis

“…Significantly low levels of cortisol likely caused our patient to respond poorly to the acute physiological stress of the shoulder manipulation and subsequent series of interscalene blocks. This interpretation is consistent with reports showing that Addison's disease can present with compromised pulmonary symptoms due to respiratory muscle weakness [13, 14]. …”

Respiratory failure was improved by growth hormone substitution in a patient with hypopituitarism

“…As the ratio of PE max and PI max , which reflects the respiratory muscle strength,7 increased after the hormone therapy, it is possible that the improvement in respiratory function was due to increases in respiratory muscle strength. It is unclear whether deficits of glucocorticoids and androgens could affect respiratory function 3. In our case, the addition of hydrocortisone and testosterone had no apparent effects on respiratory function, although we cannot exclude the possibility that replacement of these hormones contributed to the maintenance of improved muscle strength.…”

“…It is suggested that severe hypothyroidism could result in respiratory failure in some cases 3 4. The respiratory muscle strength is reportedly weakened in hypothyroidism and the weakness seems to be proportional to the degree of thyroid dysfunction 5.…”

Acute and chronic NIMV applications in COPD patients

“…Strength-load imbalance has multifactorial aspects, which may alter the coupling of respiratory neuromuscular capacity and the elastic or resistive loads against which the respiratory muscle must contract (25). Infections, malnutrition and associated generalized weakness, sleeplessness, electrolyte disturbances (26), improper drug administration including oxygen (27), fever, bronchospasm, systemic and endochrinologic pathologies (28) are all causes of this imbalance.…”