Critical care myopathy in a child.
Critical care myopathy (CCM) is an important, often unrecognized cause of weakness in the intensive care unit (ICU). We report a child who developed severe myopathy in the ICU. Our patient was newly diagnosed to have autoimmune hepatitis that may have predisposed her to toxicity from corticosteroids and neuromuscular-blocking agents, but she recovered her strength completely. Risk factors that may have predisposed this patient to CCM include underlying liver dysfunction, presence of acute lung injury, use of corticosteroids, and use of neuromuscular blockade. Given the apparent prevalence and underreporting of CCM in the ICU, it is important for rheumatology consultants to include this entity in their differential diagnosis of weakness in critically ill children and adults, and to recommend appropriate evaluation.
Newman
Arthur J
AJ
Rainbow Babies and Children's Hospital, 11100 Euclid Avenue, Cleveland, OH 44106, USA. axn4@cwru.edu
Singer
Nora G
NG
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D003402:Creatine Kinase / Q000097:blood; D003422:Critical Care; D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications / Q000628:therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D018908:Muscle Weakness / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D009466:Neuromuscular Blocking Agents / Q000009:adverse effects; D015742:Propofol / Q000009:adverse effects; D012128:Respiratory Distress Syndrome / Q000150:complications / Q000628:therapy
D000305:Adrenal Cortex Hormones; D006993:Hypnotics and Sedatives; D009466:Neuromuscular Blocking Agents; D003402:Creatine Kinase; D015742:Propofol