Risk factors for hydrocortisone myopathy in acute severe asthma

Shee, C. D.

doi:10.1016/s0954-6111(08)80040-6

Cited by 78 publications

(29 citation statements)

References 11 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: 63%

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: 63%

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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show abstract

“…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: 76%

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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“…32 No known therapy exists to prevent or enhance recovery after the development of steroid-induced myopathy although physical activity has been reported to prevent its development. 33,34 Our analysis suggests that steroid myopathy is a relatively common complication of high-dose steroid therapy for aGVHD. We limited our analysis to patients with AML/MDS and to patients surviving at least 100 days post transplant to avoid the confounding factors of prior steroid therapy as treatment for the primary malignant disorder, and early deaths from other transplant complications immediately after institution of steroid therapy for aGVHD.…”

Section: Discussionmentioning

confidence: 92%

Steroid myopathy in patients with acute graft-versus-host disease treated with high-dose steroid therapy

Lee

Oran

Saliba

et al. 2006

Bone Marrow Transplant

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High-dose steroids are the first line of treatment for acute graft-versus-host disease (aGVHD). Steroid myopathy is a debilitating steroid-induced complication that significantly impairs a patient's performance status. To determine the frequency and severity of steroid myopathy and other steroid related complications in patients with acute myeloid leukemia (AML)/myelodysplastic syndrome (MDS) who developed grade X2 aGVHD after allogeneic hematopoietic stem cell transplantation (HSCT), we performed a retrospective analysis. Patients were included in the analysis if they had a diagnosis of AML/MDS, underwent an allogeneic HSCT between January 1996 and December 2001 and developed grade X2 aGVHD that was treated with 2 mg/kg of methylprednisolone and survived at least 100 days post transplant. A total of 70 patients fulfilled our inclusion criteria. Steroid myopathy was identified in 29 (41%) patients. Steroid myopathy was generally of moderate severity with severe debilitating steroid myopathy seen in only 3% of patients. We concluded that steroid myopathy is a common complication of high-dose steroid therapy after allogeneic HSCT in AML/MDS. Interventions aimed at preventing and treating this complication are warranted and need to be explored in prospective clinical trials.

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Risk factors for hydrocortisone myopathy in acute severe asthma

Cited by 78 publications

References 11 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.

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

Steroid myopathy in patients with acute graft-versus-host disease treated with high-dose steroid therapy

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