Acute myopathy during treatment of status asthmaticus with corticosteroids and steroidal muscle relaxants.
Acute myopathy in patients being treated for severe asthma has been recognized with increasing frequency since first being described in 1977. We report three patients treated for status asthmaticus who developed severe generalized weakness. Electrophysiologic studies and muscle biopsy revealed evidence of muscle destruction. Each of these patients was treated with high-dose corticosteroids and underwent prolonged neuromuscular blockade with a steroidal muscle relaxant. A review of the literature revealed 15 similar cases. We postulate that the combined effects of corticosteroids and muscle relaxants on the muscle cell may be responsible for this myopathy. Patients treated with corticosteroids and NMBs should be carefully monitored for the development of myopathy.
Griffin
D
D
Department of Anesthesiology, University of Wisconsin, Madison.
Fairman
N
N
Coursin
D
D
Rawsthorne
L
L
Grossman
J E
JE
D000208:Acute Disease; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D001706:Biopsy; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009132:Muscles / Q000648:ultrastructure; D009135:Muscular Diseases / Q000139:chemically induced* / Q000175:diagnosis; D009460:Neurologic Examination; D003473:Neuromuscular Nondepolarizing Agents / Q000009:adverse effects*; D013224:Status Asthmaticus / Q000150:complications* / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D003473:Neuromuscular Nondepolarizing Agents