[Steroid-induced myopathy].
Steroid muscle-related involvement is a frequent but often underestimated adverse effect of steroid treatment. Clinical presentation may differentiate two features: the less frequent, represented by acute myopathy, essentially observed in resuscitation, in patients treated with high dosages, and the more frequent feature, insidious, painless, chronic myopathy, characterized by a progressive proximal deficit. Diagnosis is mostly based on the clinic, muscle biopsy should remain exceptional, performed to detect other myopathies, since there are no specific anatomopathological findings. Muscle enzymes are rarely increased, electrophysiological analyses demonstrate unspecific and variable abnormalities. Pathophysiology of steroid-induced myopathy is multifactorial, related to protein metabolism modifications (change of both metabolism and catabolism), cellular transcription, growth factors (IGF-1, myostatine). Treatment is unspecific, mostly based on the prevention that should firstly consider steroid dosage reduction.
Université Paris Descartes, Hôtel Dieu, service de médecine interne et thérapeutique, Inserm U 987, 75004 Paris, France. Serge.perrot@htd.aphp.fr
Serge
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Claire
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Le Jeunne
D000305:Adrenal Cortex Hormones / Q000009:adverse effects* / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001706:Biopsy; D004305:Dose-Response Relationship, Drug; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D018482:Muscle, Skeletal / Q000187:drug effects / Q000473:pathology; D009135:Muscular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D012307:Risk Factors
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D007166:Immunosuppressive Agents