[Steroid-induced myopathy in left-sided ulcerative colitis. Successful treatment and continued therapy with the topical steroid budesonide].
BACKGROUND
Glucocorticoids are an effective treatment of ulcerative colitis. The occurrence of steroid side effects depends on dosage and duration of steroid treatment. It may be a high as 80%. A rare side effect of glucocorticoid therapy is steroid induced myopathia. There exists an acute and a chronic form of steroid induced myopathia. Chronic steroid myopathia affects mainly the proximal musculature of the lower and upper extremities and leads to proximal muscle weakness. Histologically, an atrophy of type IIb-muscle fibers can be found. Chronic steroid myopathia occurs after prolonged treatment with higher doses of glucocorticoids.


METHODS
The case report describes a 25 year old male patient with left-sided ulcerative colitis who developed chronic steroid myopathia after several months of glucocorticoid treatment. After switching from systemic steroids to budesonide the symptoms of myopathia disappeared. Left-sided ulcerative colitis remained in remission.


CONCLUSIONS
The case documents the disappearance of a severe steroid side effect after switching from a systemic steroid to budesonide.
Caesar
I
I
Klinik und Poliklinik für Innere Medizin I, Universität Regensburg.
Gross
V
V
Roth
M
M
Andus
T
T
Hohenberger
W
W
Schölmerich
J
J
D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D019819:Budesonide; D003093:Colitis, Ulcerative / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009133:Muscular Atrophy / Q000139:chemically induced* / Q000188:drug therapy; D011239:Prednisolone / Q000008:administration & dosage / Q000009:adverse effects*; D011282:Pregnenediones / Q000008:administration & dosage*
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D011282:Pregnenediones; D019819:Budesonide; D011239:Prednisolone