Myasthenia gravis and steroid-induced myopathy of the respiratory muscles.
OBJECTIVE
We report a case of corticosteroid-induced myopathy with involvement of respiratory muscles observed in a myasthenic patient.


METHODS
A 37-years-old woman, under corticosteroid treatment for two years for typical myasthenia gravis was admitted to ICU for acute myasthenic respiratory failure. Weaning from mechanical ventilation remained impossible despite 4 plasma exchanges and azathioprine. The patient exhibited a progressive 12 kg weight loss with muscular weakness and atrophy.


RESULTS
Peripheral and diaphragmatic electromyography as well as histological study were consistent with a steroid-induced myopathy. Discontinuation of corticosteroid treatment was followed by a rapid weight gain with general improvement and allowed weaning from mechanical ventilation with a complete recovery.


CONCLUSIONS
This case provides evidence that corticosteroid-induced myopathy may be observed in myasthenia gravis and may involve the respiratory muscles as well as the peripheral musculature.
Vallet
B
B
Service de Réanimation Polyvalente, Hôpital B, CHRU, Lille, France.
Fourrier
F
F
Hurtevent
J F
JF
Parent
M
M
Chopin
C
C
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000328:Adult; D001284:Atrophy; D001379:Azathioprine / Q000627:therapeutic use; D004576:Electromyography; D005260:Female; D006801:Humans; D008176:Lung Volume Measurements; D009157:Myasthenia Gravis / Q000145:classification / Q000150:complications / Q000188:drug therapy*; D010951:Plasma Exchange; D012121:Respiration, Artificial; D012131:Respiratory Insufficiency / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D012132:Respiratory Muscles / Q000187:drug effects* / Q000503:physiopathology
D000305:Adrenal Cortex Hormones; D001379:Azathioprine