[Status asthmaticus. Acute myopathy induced by cortisone and neuropathy during resuscitation].
A female patient treated by mechanical ventilation with high doses of pancuronium and methylprednisolone for status asthmaticus presented with acute total areflexic and severe amyotrophic tetraplegia; she died after multiple organ failure. Muscle biopsy confirmed the clinical diagnosis of "acute corticosteroid myopathy", precipitated by a corticosteroid "disuse hypersensitivity" after pancuronium. The electromyogram showed a critical illness polyneuropathy, secondary to multiple organ failure. Nerve biopsy was normal. The respective parts played by corticosteroids, curare-like derivatives and intensive care in the genesis of unexplained difficulty in weaning from the ventilator are discussed.
Clinique Saint-Louis, Hôpital Régional du Nord, Ettelbruck Grand-Duché de Luxembourg.
Y
Y
De Smet
D000208:Acute Disease; D000368:Aged; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008775:Methylprednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D009102:Multiple Organ Failure / Q000209:etiology; D009135:Muscular Diseases / Q000139:chemically induced* / Q000175:diagnosis; D009422:Nervous System Diseases / Q000139:chemically induced* / Q000175:diagnosis; D009431:Neural Conduction; D010197:Pancuronium / Q000009:adverse effects / Q000627:therapeutic use; D012121:Respiration, Artificial / Q000009:adverse effects*; D012151:Resuscitation / Q000009:adverse effects / Q000379:methods; D013224:Status Asthmaticus / Q000150:complications* / Q000188:drug therapy
D010197:Pancuronium; D008775:Methylprednisolone
Etat de mal asthmatique. Myopathie aiguë cortisonique et neuropathie de réanimation.