Myoglobinuria in boys with Duchenne muscular dystrophy on corticosteroid therapy.
Myoglobinuria is a recognised complication of Duchenne muscular dystrophy (DMD), but has only once been reported in ambulant boys on corticosteroid therapy [Dubowitz V, Kinali M, Main M, Mercuri E, Muntoni F. Remission of clinical signs in early Duchenne muscular dystrophy on intermittent low-dosage prednisolone therapy. Eur J Paediatr Neurol 2002;6(3):153-9.]. We present three prednisolone-treated boys with myoglobinuria and in two cases this was recurrent. All three showed improved motor performance in response to the introduction of corticosteroids. The greater activity of steroid-treated individuals may place their dystrophin-deficient muscles under greater mechanical stress, predisposing to further muscle fibre damage and consequent myoglobinuria. Families and physicians need to have an increased awareness of this possibility and of the appropriate management of myoglobinuria.
Garrood
P
P
Institute of Human Genetics, International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK. penny.garrood@ncl.ac.uk
Eagle
M
M
Jardine
P E
PE
Bushby
K
K
Straub
V
V
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D002648:Child; D005081:Exercise Therapy / Q000009:adverse effects*; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009068:Movement / Q000502:physiology; D018485:Muscle Fibers, Skeletal / Q000378:metabolism / Q000473:pathology; D018482:Muscle, Skeletal / Q000187:drug effects* / Q000473:pathology / Q000503:physiopathology; D020388:Muscular Dystrophy, Duchenne / Q000150:complications* / Q000188:drug therapy* / Q000503:physiopathology; D009211:Myoglobin / Q000378:metabolism; D009212:Myoglobinuria / Q000139:chemically induced* / Q000473:pathology / Q000503:physiopathology; D011239:Prednisolone / Q000009:adverse effects; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000473:pathology / Q000503:physiopathology; D013314:Stress, Mechanical; D016896:Treatment Outcome; D028761:Withholding Treatment
D000305:Adrenal Cortex Hormones; D009211:Myoglobin; D011239:Prednisolone